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USMLE findings
USMLE classical findings & associations
| Disease/Finding | Association |
|---|---|
| Actinic keratosis | Precedes squamous cell carcinoma |
| Addison's disease | Primary adrenocortical deficiency |
| Albright's syndrome | Polyostotic fibrous dysplasia- precocious puberty- café-au-lait spots- short stature- young girls |
| Albuminocytologic dissociation | Guillain-Barre - Increased protein in CSF with only modest increase in cell count |
| Alport's syndrome | Hereditary nephritis with nerve deafness |
| Anti-basement membrane Ab | Goodpasture's |
| Anti-centromere Ab | Scleroderma (CREST) |
| Anti-dsDNA Ab (aka ANA Ab) | SLE - Type III hypersensitivity |
| Anti-epithelial cell Ab | Pemphigus vulgaris |
| Anti-gliadin Ab | Celiac |
| Anti-histone Ab | Drug-induced SLE |
| Anti-IgG Ab | RA |
| Anti-mitochondrial Ab | Primary biliary cirrhosis |
| Anti-neutrophil Ab | Vasculitis |
| Anti-platelet Ab | ITP |
| Arachnodactyly | Marfan's |
| Argyll Robertson pupil | Tertiary syphilis (Prostitute pupil) - accomodates but does not react |
| Arnold-Chiari malformation | Cerebellar tonsillar herniation |
| Aschoff bodies | Rheumatic fever |
| Atrophy of the mamillary bodies | Wernicke's encephalopathy |
| Auer rods | AML - Promyelocytic |
| Autosplenectomy | Sickle cell |
| 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 |
| Becker's muscular dystrophy | Less than Duchenne's |
| Bell's palsy | LMN CN VII palsy |
| Bence-Jones proteins | Multiple myeloma- Waldenstrom's macroglobulinemia - MM = kappa or lambda Ig light chains; WM = IgM |
| Berger's disease | IgA nephropathy |
| Bernard-Soulier disease | Platelet adhesion defect |
| Bilateral hilar adenopathy + uveitis | Sarcoid |
| Birbeck granules on EM | Langerhan's cell histiocytosis (Histiocytosis X) - Tennis racquets |
| Birbeck granules on EM (diseases) | Eosinophilic granuloma- Hand-Schuller-Christian Disease- Letterer-Siwe disease |
| Bloody tap on lumbar puncture | Subarachnoid hemorrhage |
| "Blue bloater" | Chronic bronchitis |
| Blue-domed cysts | Fibrocystic change of the breast |
| Blue sclera | Osteogenesis imperfecta |
| Boot-shaped heart on X-ray | RVH- Tet |
| Bouchard's nodes | Osteoarthritis - PIP |
| Boutonniere deformity | RA |
| Branching rods in oral infection | Actinomyces israelii |
| "Brown tumor" of bone | Hemorrhage - Due to Hyperparathyroidism- osteitis fibrosa cystica (von Recklinghousen's disease) |
| Bruton's disease | X-linked agammaglobulinemia |
| Budd-Chiari syndrome | Posthepatic venous thrombosis |
| Buerger's disease | Small/medium artery vasculitis |
| Burkitt's lymphoma | 8;14 - EBV |
| Burton's lines | Lead poisoning |
| C-ANCA | Wegener's |
| Café-au-lait spots on skin | Neurofibromatosis |
| Caisson disease | Gas emboli |
| Calf pseudohypertrophy | Duchenne |
| Call-Exner bodies | Granulosa-theca cell tumor of the ovary |
| Cardiomegaly with apical atrophy | Chagas disease |
| Cerebriform nuclei | Mycosis fungoides (Sezary syndrome) - Cutaneous T-Cell lymphoma |
| Chagas disease | Trypanosoma Cruzi |
| Chancre | Primary Syphilis - painless lesion |
| Chancroid | Haemophilus ducreyi - painful lesion |
| Charcot's triad | MS--nystagmus- intention tremor- scanning speech; Cholangitis--jaundice- RUQ pain- fever |
| Charcot-Leyden crystals | Bronchial Asthma - Eosinophil membranes |
| Chediak-Higashi disease | Phagocyte deficiency |
| Cherry-red spot on macula | Tay-Sachs- niemann-Pick- central retinal artery occlusion |
| Cheyne-Stokes respirations | Central apnea in CHF and inc. intracranial pressure |
| "Chocolate cysts" | Endometriosis - frequently both ovaries |
| Chronic atrophic gastritis | 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; Mono |
| Cold intolerance | Hypothyroidism |
| Condylomata lata | Secondary syphilis - infectious pink or grey patches on skin |
| Continuous machinery murmur | PDA |
| Cori's disease | Debranching enzyme deficiency |
| Cotton-wool spots | Chronic HTN |
| Cough- conjuncitivitis- coryza- & fever | Measles |
| Councilman bodies | Hepatitis - toxic or viral |
| Cowdry type A bodies | Herpesvirus |
| Crescents in Bowman's capsule | Goodpasture |
| 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 mucus plugs |
| Cushing's ulcer | Acute gastric ulcer associated with CNS injury |
| D-Dimer | DIC |
| Depigmentation of neurons in substantia nigra | Parkinson's - basal ganglia disorder - rigidity/resting tremor/bradykinesia |
| Dermatitis- demetia- diarrhea | Pellagra - Niacin (B# deficiency) |
| Diabetes Insipidus + exophthalmos + skull lesions | Hand-Schuller-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 - bones become dense and polished (resembling ivory) |
| Edwards' syndrome | Trisomy 18 (rocker-bottom feet - low set ears - heart disease) |
| Eisenmenger's syndrome | Late cyanosis shunt - Reversal of L-->R shunt |
| Elastic skin | Ehlers-Danlos |
| Erythema chronicum migrans | Lyme disease |
| Fanconi's syndrome | Proximal tubular reabsorption defect |
| Fat - female - forty - and fertile | Acute cholecystitis |
| Fatty liver | Alcoholism |
| Ferruginous bodies | Asbestos |
| Gardner's syndrome | Colon polyps with osteomas and soft tissue tumors |
| Gaucher's disease | Glucocerebrosidase deficiency |
| Ghon complex | Primary TB |
| Gilbert's disease | Benign congenital unconjugated hyperbilirubinemia |
| Glanzmann's thrombasthenia | Defect in plt aggregation |
| Goodpasture | Anti-BM |
| Gower's maneuver | Duchenne's (Pt uses arms to help legs pick self up off floor) |
| Guillain-Barre syndrome | Idiopathic polyneuritis |
| "Hair-on-end" appearance on X-ray | B-thalassemia & sickle cell (Extramedullary hematopoiesis) |
| Hand-Schuler-Christian disease | Chronic progressive histiocytosis |
| HbF | Thalassemia major |
| HbS | Sickle cell |
| hCG elevated | Choriocarcinoma- hydatidiform mole |
| Heberden's nodes | Osteoarthritis - DIP |
| Heinz bodies | G6PD deficiency |
| Henoch-Schonlein purpura | Hypersensitivity vasculitis - Assoc with hemorrhagic uticaria and URIs |
| Heterophil Ab | Mono (EBV) |
| High-output cardiac failure (dilated cardiomyopathy) | Wet beriberi (Thiamine B1 deficiency) |
| HLA-B27 | Reiter's syndrome- ankylosing spondylitis |
| HLA-DR3 or HLA-DR4 | DM I |
| Homer-Wright rosettes | Neuroblastoma |
| Honeycomb lung on X-ray | Interstitial fibrosis |
| Horner's syndrome | Ptosis- miosis- anhidrosis |
| Howell-Jolly bodies | Splenectomy |
| Huntington's disease | Caudate degeneration - Auto dominant |
| Hyperphagia + hypersexuality + hyperorality + hyperdocility | Kluver-Bucy sundrome - problem with amygdala |
| Hyperpigmentation of skin | Addison's disease (primary adrenal insufficiency) |
| Hypersegmented neutrophils | Macrocytic anemia |
| HTN + hypokalemia | Conn's syndrome |
| Hypochromic- microcytic anemia | Iron-deficiency anemia- lead poisoning |
| Increased AFP in amniotic fluid/maternal serum | Anencephaly/spina bifida |
| Increased uric acid levels | Gout- Lesch-Nyhan syndrome- myeloproliferative disorders- loop and thiazide diuretics |
| Intussusception | Adenovirus - how? Hyperplasia of peyer's patches |
| Janeway lesions | Endocarditis |
| Jarish-Herxheimer reaction Syphilis - due to overaggressive treatment of an asymptomatic pt --> rapid lysis | (blank) |
| Job's syndrome | Neutrophil chemotaxis abnormality |
| Kaposi's Sarcoma | AIDS in MSM |
| Kartagener's syndrome | Dynein defect |
| Keyser-Fleischer rings | High free copper (decreased ceruloplasmin) - Wilson's disease |
| Keratin pearls | Squamous cell carcinoma |
| Kimmelstiel-Wilson nodules | Diabetic nephropathy |
| Kluver-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 - Fibrillin gene defect |
| Lesch-Nyhan syndrome | HGPRT - Nucleotide salvage pathway defect |
| Lewy bodies | Parkinson's |
| Libman-Sacks disease | Endocarditis - Assoc 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" 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) | MS |
| Monoclonal Ab spike | Multiple Myeloma- MGUS- Waldenstrom's macroglobulinemia - Called "M protein" - IgG and IgA elevated |
| 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 |
| Neurofibrillary tangles | Alzheimer's |
| Niemann-Pick disease | Sphingomyelinase deficiency |
| No lactation postpartum | Sheehan's syndrome (pit. Infarct) |
| 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 & buttocks | Henoch-Schonlein purpura |
| P-ANCA | Polyarteritis Nodosa |
| Pancoast's tumor | Superior sulcus tumor (bronchogenic apical tumor) - Horner's syndrome |
| Pannus | Rheumatoid arthritis |
| Parkinson's | Nigrostriatal dopamine depletion |
| Periosteal elevation on X-ray | Pyogenic osteomyelitis |
| Peutz-Jeghers syndrome | Benign polyposis |
| Peyronie's disease | Penile fibrosis |
| Philadelphia chromosome | CML - 9:22- bcr-abl |
| Pick bodies | Pick's disease |
| Pick's disease | Progressive dementia- similar to Alzheimer's |
| "Pink puffer" | Emphysema |
| "Pink puffer" | Centroacinar (smoking)- Panacinar (a-1 antitrypsin def.) |
| Plummer-vinson syndrome | Esophageal webs w/ iron deficiency anemia |
| Podagra | Gout |
| Podagra | Severe pain in MP joint of hallux |
| Podocyte fusion | Minimal change disease |
| Polyneuropathy- cardiac pathology- and edema | Dry beriberi - Thiamine (B1) deficiency |
| Polyneuropathy preceded by GI/Resp infection | Guillain-Barre |
| Pompe's disease | Glucosidase deficiency - Cardiomegaly |
| Port-wine stain | Hemangioma |
| Positive "anterior drawer" sign | ACL injury |
| Pott's disease | Verterbral TB |
| Pseudopalisade tumor cell arrangement | Glioblastoma multiforme |
| Psudorosettes | Ewing's sarcoma |
| Ptosis- miosis- anhidrosis | Horner's syndrome |
| Rash on palms and soles | Secondary syphilis- RMSF |
| Raynaud's syndrome | Recurrent vasospasm in extremities |
| RBC casts in urine | Acute glomerulonephritis |
| Recurrent pulmonary Pseudomonas and S. Aureus infxns | CF |
| Red urine in the morning | Paroxysmal nocturnal hemoglobinuria |
| Reed-Sternberg cells | Hodgkin's |
| Increased Reid index | Chronic bronchitis |
| Reinke crystals | Leydig cell tumor |
| Reiter's syndrome | Urethritis- conjunctivitis- arthritis |
| Renal cell carcinoma + cavernous hemagiomas + adenomas | von Hippel-Lindau disease |
| Renal epithelial casts in urine | Acute toxic/viral nephrosis |
| Rhomboid crystals- positively birefringent | Pseudogout |
| Rib notching | Coarc |
| Roth's spots in retina | Endocarditis |
| Rotor's syndrome | Congenital conjugated hyperbilirubinemia |
| Rouleaux formation | Multiple myeloma |
| Russell bodies | Multiple myeloma |
| S3 | L-->R shunt (VSD- PDA- ASD)- mitral regurg- LV failure (CHF) |
| S4 | Aortic stenosis- hypertrophic subaortic stenosis |
| Schiller-duval bodies | Yolk sac tumor |
| Senile plaques | Alzheimer's |
| Sezary syndrome | Cutaneous T-cell lymphoma |
| Sezary syndrome | Mycosis fungoides |
| Sheehan's syndrome | Postpartum pituitary necrosis |
| Shwartzman reaction | N. meningitidis |
| Signet-ring cells | Gastric carcinoma |
| Simian crease | Down's |
| Sipple's syndrome | MEN type IIa |
| Sjogren's syndrome | Dry eyes- dry mouth- arthritis |
| Skip lesions | Crohn's |
| Slapped cheeks | Erythema infectiosum (fifth disease) -Parvo |
| Smith Ag | 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 |
| "Strawberry tongue" | Scarlet fever - Strep pyo |
| Streak ovaries | Turner's |
| String sign on X-ray | Crohn's |
| Subepithelial humps on EM | Poststreptococcal glomerulonephritis |
| Suboccipital lymphadenopathy | Rubella |
| Sulfur granules | A. Israelii |
| Swollen gums- bruising- poor wound healing- anemia | Scurvy (ascorbic acid (vit C) deficiency) - Hydroxylation of Pro- Lys in collagen synthesis |
| Systolic ejection murmur (crescendo-decrescendo) | Aortic stenosis |
| t(8;14) | Burkitt's - c-myc |
| t(9;22) | CML - bcr-abl; Philadelphia chromosome |
| t(14;18) | Follicular lymphoma - bcl-2 |
| Tabes dorsalis | Tertiary syphilis |
| Tendon xanthomas (clasically achilles) | Familial hypercholesterolemia |
| Thumb sign on lateral X-ray | Epiglottitis - HiB |
| 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 | Due to PE / triad:Blood stasis- endothelial damage- hypercoagulability |
| von Recklinghausen's disease | Neurofibromatosis with café-au-lait spots |
| von Recklinghausen's disease of bone | Osteitis fibrosa cystica - "brown tumor" |
| Wallenberg's syndrome | PICA 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 - assoc with Adult PCKD |
| Xanthochromia (CSF) | Subarachnoid hemorrhage |
| Xerostomia + arthritis + keratocunjunctivitis sicca | Sjogren's |
| Zenker's diverticulum | Upper GI diverticulum |
| Zollinger-Ellison syndrome | Gastrin-secreting tumor |
| Zollinger-Ellison syndrome | Ulcers |
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