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