Classic Findings

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Actinic keratosis   Often precedes squamous cell carcinoma  
Addison’s disease   1° adrenocortical deficiency  
Albright’s syndrome   Polyostotic fibrous dysplasia, precocious puberty, café-au-lait spots, short stature, young girls  
Albuminocytologic dissociation   Guillain-Barré (↑ protein in CSF with only modest ↑ in cell count)  
Alport’s syndrome   Hereditary nephritis with nerve deafness  
Anti–basement membrane antibodies   Goodpasture’s syndrome  
Anticentromere antibodies   Scleroderma (CREST)  
Anti-double-stranded DNA antibodies (ANA antibodies)   SLE (type III hypersensitivity)  
Anti–epithelial cell antibodies   Pemphigus vulgaris  
Antigliadin antibodies   Celiac disease  
Antihistone antibodies   Drug-induced SLE  
Anti-IgG antibodies   Rheumatoid arthritis  
Antimitochondrial antibodies   1° biliary cirrhosis  
Antineutrophil antibodies   Vasculitis  
Antiplatelet antibodies   Idiopathic thrombocytopenic purpura  
Arachnodactyly   Marfan’s syndrome  
Argyll Robertson pupil   Neurosyphilis  
Arnold-Chiari malformation   Cerebellar tonsillar herniation  
Aschoff bodies   Rheumatic fever  
Atrophy of the mammillary bodies   Wernicke’s encephalopathy  
Auer rods   Acute myelogenous leukemia (especially the promyelocytic type)  
Autosplenectomy   Sickle cell anemia  
Babinski’s sign   UMN lesion  
Baker’s cyst in popliteal fossa   Rheumatoid arthritis  
“Bamboo spine” on x-ray   Ankylosing spondylitis  
Bartter’s syndrome   Hyperreninemia  
Basophilic stippling of RBCs   Lead poisoning  
Becker’s muscular dystrophy   Defective dystrophin; less severe than Duchenne’s  
Bell’s palsy   LMN CN VII palsy  
Bence Jones proteins   Multiple myeloma (kappa or lambda Ig light chains in urine), Waldenström’s macroglobulinemia (IgM)  
Berger’s disease   IgA nephropathy  
Bernard-Soulier disease   Defect in platelet adhesion  
Bilateral hilar adenopathy, uveitis   Sarcoidosis  
Birbeck granules on EM   Histiocytosis X (eosinophilic granuloma)  
Bloody tap on LP   Subarachnoid hemorrhage  
“Blue bloater”   Chronic bronchitis  
Blue-domed cysts   Fibrocystic change of the breast  
Blue sclera   Osteogenesis imperfecta  
Boot-shaped heart on x-ray   Tetralogy of Fallot; RVH  
Bouchard’s nodes   Osteoarthritis (PIP swelling 2° to osteophytes)  
Boutonnière deformity   Rheumatoid arthritis  
Branching rods in oral infection   Actinomyces israelii  
“Brown tumor” of bone   Hemorrhage causes brown color of osteolytic cysts: 1. Hyperparathyroidism 2. Osteitis fibrosa cystica (von Recklinghausen’s disease)  
Brushfield’s spots   Down syndrome  
Bruton’s disease   X-linked agammaglobulinemia  
Budd-Chiari syndrome   Posthepatic venous thrombosis  
Buerger’s disease   Small/medium-artery vasculitis  
Burkitt’s lymphoma   8:14 translocation; associated with EBV  
Burton’s lines   Lead poisoning  
C-ANCA, P-ANCA   Wegener’s granulomatosis, polyarteritis nodosa  
Café-au-lait spots on skin   Neurofibromatosis  
Caisson disease   Gas emboli  
Calf pseudohypertrophy   Duchenne’s muscular dystrophy  
Call-Exner bodies   Granulosa-theca cell tumor of the ovary  
Cardiomegaly with apical atrophy   Chagas’ disease  
Cerebriform nuclei   Mycosis fungoides (cutaneous T-cell lymphoma)  
Chagas’ disease   Trypanosome infection  
Chancre   1° syphilis (not painful)  
Chancroid   Haemophilus ducreyi (painful)  
Charcot’s triad   Multiple sclerosis (nystagmus, intention tremor, scanning speech), cholangitis (jaundice, RUQ pain, fever)  
Charcot-Leyden crystals   Bronchial asthma (eosinophil membranes)  
Chédiak-Higashi disease   Phagocyte deficiency  
Cherry-red spot on macula   Tay-Sachs, Niemann-Pick disease, central retinal artery occlusion  
Cheyne-Stokes respirations   Central apnea in CHF and ↑ intracranial pressure  
“Chocolate cysts”   Endometriosis (frequently involves both ovaries)  
Chronic atrophic gastritis   Predisposition to gastric carcinoma  
Chvostek’s sign   Hypocalcemia (facial muscle spasm upon tapping)  
Clear cell adenocarcinoma of the vagina   DES exposure in utero  
Clue cells   Gardnerella vaginitis  
Codman’s triangle on x-ray   Osteosarcoma  
Cold agglutinins   Mycoplasma pneumoniae, infectious mononucleosis  
Cold intolerance   Hypothyroidism  
Condylomata lata   2° syphilis  
Continuous machinery murmur   Patent ductus arteriosus  
Cori’s disease   Debranching enzyme deficiency  
Cotton-wool spots   Chronic hypertension  
Cough, conjunctivitis, coryza + fever   Measles  
Councilman bodies   Toxic or viral hepatitis  
Cowdry type A bodies   Herpesvirus  
Crescents in Bowman’s capsule   Rapidly progressive crescentic glomerulonephritis  
Crigler-Najjar syndrome   Congenital unconjugated hyperbilirubinemia  
Curling’s ulcer   Acute gastric ulcer associated with severe burns  
Currant-jelly sputum   Klebsiella  
Curschmann’s spirals   Bronchial asthma (whorled mucous plugs)  
Cushing’s ulcer   Acute gastric ulcer associated with CNS injury  
D-dimers   DIC  
Depigmentation of neurons in substantia nigra   Parkinson’s disease (basal ganglia disorder––rigidity, resting tremor, bradykinesia)  
Dermatitis, dementia, diarrhea   Pellagra (niacin, vitamin B3 deficiency)  
Diabetes insipidus + exophthalmos + lesions of the skull   Hand-Schüller-Christian disease  
Dog or cat bite   Pasteurella multocida  
Donovan bodies   Granuloma inguinale  
Dressler’s syndrome   Post-MI fibrinous pericarditis  
Dubin-Johnson syndrome   Congenital conjugated hyperbilirubinemia (black liver)  
Duchenne’s muscular dystrophy   Deleted dystrophin gene (X-linked recessive)  
Eburnation   Osteoarthritis (polished, ivory-like appearance of bone)  
Edwards’ syndrome   Trisomy 18 associated with rocker-bottom feet, low-set ears, heart disease  
Eisenmenger’s complex   Late cyanosis shunt (uncorrected L → R shunt becomes R → L shunt)  
Elastic skin   Ehlers-Danlos syndrome  
Erb-Duchenne palsy   Superior trunk brachial plexus injury (“waiter’s tip”)  
Erythema chronicum migrans   Lyme disease  
Fanconi’s syndrome   Proximal tubular reabsorption defect  
“Fat, female, forty, and fertile”   Acute cholecystitis  
Fatty liver   Alcoholism  
Ferruginous bodies   Asbestosis  
Gardner’s syndrome   Colon polyps with osteomas and soft tissue tumors  
Gaucher’s disease   Glucocerebrosidase deficiency  
Ghon focus   1° TB  
Gilbert’s syndrome   Benign congenital unconjugated hyperbilirubinemia  
Glanzmann’s thrombasthenia   Defect in platelet aggregation  
Goodpasture’s syndrome   Autoantibodies against alveolar and glomerular basement membrane proteins  
Gowers’ maneuver   Duchenne’s (use of patient’s arms to help legs pick self off the floor)  
Guillain-Barré syndrome   Idiopathic polyneuritis  
“Hair-on-end” appearance on x-ray   β-thalassemia, sickle cell anemia (extramedullary hematopoiesis)  
Hand-Schüller-Christian disease   Chronic progressive histiocytosis  
HbF   Thalassemia major  
HbS   Sickle cell anemia  
hCG elevated   Choriocarcinoma, hydatidiform mole (occurs with and without embryo)  
Heberden’s nodes   Osteoarthritis (DIP swelling 2° to osteophytes)  
Heinz bodies   G6PD deficiency  
Henoch-Schönlein purpura   Hypersensitivity vasculitis associated with hemorrhagic urticaria and URIs  
Heterophil antibodies   Infectious mononucleosis (EBV)  
High-output cardiac failure (dilated cardiomyopathy)   Wet beriberi (thiamine, vitamin B1 deficiency)  
HLA-B27   Reiter’s syndrome, ankylosing spondylitis  
HLA-DR3 or -DR4   Diabetes mellitus type 1 (caused by autoimmune destruction of β cells)  
Homer Wright rosettes   Neuroblastoma  
Honeycomb lung on x-ray   Interstitial fibrosis  
Horner’s syndrome   Ptosis, miosis, and anhidrosis  
Howell-Jolly bodies   Splenectomy (or nonfunctional spleen)  
Huntington’s disease   Caudate degeneration (autosomal dominant)  
Hyperphagia + hypersexuality + hyperorality + hyperdocility   Klüver-Bucy syndrome (amygdala)  
Hyperpigmentation of skin   1° adrenal insufficiency (Addison’s disease)  
Hypersegmented neutrophils   Macrocytic anemia  
Hypertension + hypokalemia   Conn’s syndrome  
Hypochromic microcytosis   Iron deficiency anemia, lead poisoning  
Increased α-fetoprotein in amniotic fluid/maternal serum   Anencephaly, spina bifida (neural tube defects)  
Increased uric acid levels   Gout, Lesch-Nyhan syndrome, myeloproliferative disorders, loop and thiazide diuretics  
Intussusception   Adenovirus (causes hyperplasia of Peyer’s patches)  
Janeway lesions   Endocarditis  
Jarisch-Herxheimer reaction   Syphilis—overaggressive treatment of an asymptomatic patient that causes symptoms due to rapid lysis  
Job’s syndrome   Neutrophil chemotaxis abnormality  
Kaposi’s sarcoma   AIDS in MSM (men who have sex with men)  
Kartagener’s syndrome   Dynein defect  
Kayser-Fleischer rings   Wilson’s disease  
Keratin pearls   Squamous cell carcinoma  
Kimmelstiel-Wilson nodules   Diabetic nephropathy  
Klüver-Bucy syndrome   Bilateral amygdala lesions  
Koilocytes   HPV  
Koplik spots   Measles  
Krukenberg tumor   Gastric adenocarcinoma with ovarian metastases  
Kussmaul hyperpnea   Diabetic ketoacidosis  
Lens dislocation + aortic dissection + joint hyperflexibility   Marfan’s syndrome (fibrillin deficit)  
Lesch-Nyhan syndrome   HGPRT deficiency  
Lewy bodies   Parkinson’s disease  
Libman-Sacks disease   Endocarditis associated with SLE  
Lines of Zahn   Arterial thrombus  
Lisch nodules   Neurofibromatosis (von Recklinghausen’s disease)  
Low serum ceruloplasmin   Wilson’s disease  
Lucid interval   Epidural hematoma  
“Lumpy-bumpy” appearance of glomeruli on immunofluorescence   Poststreptococcal glomerulonephritis  
Lytic bone lesions on x-ray   Multiple myeloma  
Mallory bodies   Alcoholic liver disease  
Mallory-Weiss syndrome   Esophagogastric lacerations  
McArdle’s disease   Muscle phosphorylase deficiency  
McBurney’s sign   Appendicitis  
MLF syndrome (INO)   Multiple sclerosis  
Monoclonal antibody spike   Multiple myeloma (called the M protein; usually IgG or IgA), MGUS (monoclonal gammopathy of undetermined significance), Waldenström’s (M protein = IgM) macroglobulinemia  
Myxedema   Hypothyroidism  
Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis   Wegener’s and Goodpasture’s (hemoptysis and glomerular disease)  
Needle-shaped, negatively birefringent crystals   Gout  
Negri bodies   Rabies  
Nephritis + cataracts + hearing loss   Alport’s syndrome  
Neurofibrillary tangles   Alzheimer’s disease  
Niemann-Pick disease   Sphingomyelinase deficiency  
No lactation postpartum   Sheehan’s syndrome (pituitary infarction)  
Nutmeg liver   CHF  
Occupational exposure to asbestos   Malignant mesothelioma  
“Orphan Annie” nuclei   Papillary carcinoma of the thyroid  
Osler’s nodes   Endocarditis  
Owl’s eye   CMV  
Painless jaundice   Pancreatic cancer (head)  
Palpable purpura on legs and buttocks   Henoch-Schönlein purpura  
Pancoast’s tumor   Bronchogenic apical tumor associated with Horner’s syndrome  
Pannus   Rheumatoid arthritis  
Parkinson’s disease   Nigrostriatal dopamine depletion  
Periosteal elevation on x-ray   Pyogenic osteomyelitis  
Peutz-Jeghers syndrome   Benign polyposis  
Peyronie’s disease   Penile fibrosis  
Philadelphia chromosome (bcr-abl )   CML (may sometimes be associated with AML)  
Pick bodies   Pick’s disease  
Pick’s disease   Progressive dementia, similar to Alzheimer’s  
“Pink puffer”   Emphysema (centroacinar [smoking], panacinar [α1-antitrypsin deficiency])  
Plummer-Vinson syndrome   Esophageal webs with iron deficiency anemia  
Podagra   Gout (MP joint of hallux)  
Podocyte fusion   Minimal change disease  
Polyneuropathy, cardiac pathology, and edema   Dry beriberi (thiamine, vitamin B1 deficiency)  
Polyneuropathy preceded by GI or respiratory infection   Guillain-Barré syndrome  
Pompe’s disease   Lysosomal glucosidase deficiency associated with cardiomegaly  
Port-wine stain   Hemangioma  
Positive anterior “drawer sign”   Anterior cruciate ligament injury  
Pott’s disease   Vertebral tuberculosis  
Pseudopalisade tumor cell arrangement   Glioblastoma multiforme  
Pseudorosettes   Ewing’s sarcoma  
Ptosis, miosis, anhidrosis   Horner’s syndrome (Pancoast’s tumor)  
Rash on palms and soles   2° syphilis, Rocky Mountain spotted fever  
Raynaud’s syndrome   Recurrent vasospasm in extremities  
RBC casts in urine   Acute glomerulonephritis  
Recurrent pulmonary Pseudomonas and S. aureus infections   Cystic fibrosis  
Red urine in the morning   Paroxysmal nocturnal hemoglobinuria  
Reed-Sternberg cells   Hodgkin’s lymphoma  
Reid index (increased)   Chronic bronchitis  
Reinke crystals   Leydig cell tumor  
Reiter’s syndrome   Urethritis, conjunctivitis, arthritis  
Renal cell carcinoma + cavernous hemangiomas + adenomas   von Hippel–Lindau disease  
Renal epithelial casts in urine   Acute toxic/viral nephrosis  
Rhomboid crystals, positively birefringent   Pseudogout  
Rib notching   Coarctation of aorta  
Roth’s spots in retina   Endocarditis  
Rotor’s syndrome   Congenital conjugated hyperbilirubinemia  
Rouleaux formation (RBCs)   Multiple myeloma  
Russell bodies   Multiple myeloma  
S3   Left-to-right shunt (VSD, PDA, ASD), mitral regurgitation, LV failure (CHF)  
S4   Aortic stenosis, hypertrophic subaortic stenosis  
Schiller-Duval bodies   Yolk sac tumor  
Senile plaques   Alzheimer’s disease  
Sézary syndrome   Cutaneous T-cell lymphoma  
Sheehan’s syndrome   Postpartum pituitary necrosis  
Shwartzman reaction   Neisseria meningitidis  
Signet-ring cells   Gastric carcinoma  
Simian crease   Down syndrome  
Sipple’s syndrome   MEN type IIa  
Sjögren’s syndrome   Dry eyes, dry mouth, arthritis  
Skip lesions   Crohn’s  
Slapped cheeks   Erythema infectiosum (fifth disease)  
Smith antigen   SLE  
“Smudge cell”   CLL  
Soap bubble on x-ray   Giant cell tumor of bone  
Spike and dome on EM   Membranous glomerulonephritis  
Spitz nevus   Benign juvenile melanoma  
Splinter hemorrhages in fingernails   Endocarditis  
Starry-sky pattern   Burkitt’s lymphoma  
“Strawberry tongue”   Scarlet fever  
Streaky ovaries   Turner’s syndrome  
String sign on x-ray   Crohn’s disease  
Subepithelial humps on EM   Poststreptococcal glomerulonephritis  
Suboccipital lymphadenopathy   Rubella  
Sulfur granules   Actinomyces israelii  
Swollen gums, bruising, poor wound healing, anemia   Scurvy (ascorbic acid, vitamin C deficiency)—vitamin C is necessary for hydroxylation of proline and lysine in collagen synthesis  
Systolic ejection murmur (crescendo-decrescendo)   Aortic valve stenosis  
t(8;14)   Burkitt’s lymphoma (c-myc activation)  
t(9;22)   Philadelphia chromosome, CML (bcr-abl hybrid)  
t(14;18)   Follicular lymphomas (bcl-2 activation)  
Tabes dorsalis   3° syphilis  
Tendon xanthomas (classically Achilles)   Familial hypercholesterolemia  
Thumb sign on lateral x-ray   Epiglottitis (Haemophilus influenzae)  
Thyroidization of kidney   Chronic bacterial pyelonephritis  
Tophi   Gout  
“Tram-track” appearance on LM   Membranoproliferative glomerulonephritis  
Trousseau’s sign   Visceral cancer, pancreatic adenocarcinoma (migratory thrombophlebitis), hypocalcemia (carpal spasm)  
Virchow’s node   Left supraclavicular node enlargement from metastatic carcinoma of the stomach  
Virchow’s triad   Pulmonary embolism (triad = blood stasis, endothelial damage, hypercoagulation)  
von Recklinghausen’s disease   Neurofibromatosis with café-au-lait spots  
von Recklinghausen’s disease of bone   Osteitis fibrosa cystica (“brown tumor”)  
Wallenberg’s syndrome   Posterior Inferior Cerebellar Artery thrombosis  
Waterhouse-Friderichsen syndrome   Adrenal hemorrhage associated with meningococcemia  
Waxy casts   Chronic end-stage renal disease  
WBC casts in urine   Acute pyelonephritis  
WBCs in urine   Acute cystitis  
Wermer’s syndrome   MEN type I  
Whipple’s disease   Malabsorption syndrome caused by Tropheryma whippelii  
Wilson’s disease   Hepatolenticular degeneration  
“Wire loop” appearance on LM   Lupus nephropathy  
“Worst headache of my life”   Berry aneurysm—associated with adult polycystic kidney disease  
Xanthochromia (CSF)   Subarachnoid hemorrhage  
Xerostomia + arthritis + keratoconjunctivitis sicca   Sjögren’s syndrome  
Zenker’s diverticulum   Upper GI diverticulum  
Zollinger-Ellison syndrome   Gastrin-secreting tumor associated with ulcers  


   

 
 

 
 

 

 

 
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