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FA Classic Findings
Question | Answer |
---|---|
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 sclera | Osteogenesis imperfecta |
Blue-domed cysts | Fibrocystic change of the breast |
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) |
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; “starry sky” appearance on histology |
Burton’s lines | Lead poisoning |
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 |
c-ANCA, p-ANCA | Wegener’s granulomatosis, microscopic polyangiitis |
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 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 (C5–C6) 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” (crew-cut) | β-thalassemia, sickle cell anemia (extramedullary hematopoiesis) |
appearance on x-ray | |
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 | Wet beriberi (thiamine, vitamin B1 deficiency) |
(dilated cardiomyopathy) | |
HLA-B27 | Reiter’s syndrome, ankylosing spondylitis |
HLA-DR3 or -DR4 | Diabetes mellitus type 1 (caused by autoimmune destruction of β cells) |
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 | Poststreptococcal glomerulonephritis |
glomeruli on immunofluorescence | |
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 | Wegener’s and Goodpasture’s (hemoptysis and glomerular disease) |
necrotizing glomerulonephritis | |
Needle-shaped, negatively | Gout |
birefringent crystals | |
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 |
“Pink puffer” | Emphysema (centroacinar [smoking], panacinar [α1-antitrypsin deficiency]) |
“Smudge cell” | CLL |
“Strawberry tongue” | Scarlet fever |
“Tram-track” appearance on LM | Membranoproliferative glomerulonephritis |
“Wire loop” appearance on LM | Lupus nephropathy |
“Worst headache of my life” | Berry aneurysm––associated with adult polycystic kidney disease |
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 |
Plummer-Vinson syndrome | Esophageal webs with iron deficiency anemia |
Podagra | Gout (MP joint of hallux) |
Podocyte fusion | Minimal change disease |
Polyneuropathy preceded by GI or respiratory infection | Guillain-Barré syndrome |
Polyneuropathy, cardiac pathology, and edema | Dry beriberi (thiamine, vitamin B1 deficiency) |
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 |
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 |
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 |
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(14;18) | Follicular lymphomas (bcl-2 activation) |
t(8;14) | Burkitt’s lymphoma (c-myc activation) |
t(9;22) | Philadelphia chromosome, CML (bcr-abl hybrid) |
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 |
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 | 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 |
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 |