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Classic Findings
Classic findings for USMLE review
| Disease/Finding | Association |
|---|---|
| Actinic keratosis | Often 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-Barré (↑ protein in CSF with only modest ↑ in cell count) |
| Alport's syndrome | Hereditary nephritis with nerve deafness |
| Anti-basement membrane | Goodpasture's syndrome |
| Anticentromere antibodies | Scleroderma (CREST) |
| Anti-double-stranded DNA antibodies (ANA antibodies) | SLE (type 3 hypersensitivity) |
| Anti-epithelial cell | 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 tonsil herniation |
| Aschoff bodies | Rheumatic fever |
| Atrophy of the mammillary bodies | Wernicke's encephalopathy |
| Auer rodes | 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 plasy |
| Bence Jones proteins | Mulitple myeloma (kappa or lambda kight chains in urine), Waldenstrom'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 | Tetrology of Fallot; RVH |
| Bouchard's nodes | Osteoarthritis (PIP swelling secondary to osteophytes) |
| Boutonniere's 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 | 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 increased cranial pressure |
| "Chocolate cysts" | Endometriosis (frequntly involves both ovaries) |
| Chronic atrophic gastritis | Predisposition to gastric carcinoma |
| Chvostek's sign | Hypocalcemia (fascial 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 | Secondary 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 |
| Current-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 diease (basal ganglia disorder - rigidity, resting tremor, bradykinesia) |
| Dermatitis, dementia, diarrhea | Pellagra (niacin, vitamin B3 deficiency) |
| Diabetes insipidus + exophthalmos + lesions of skull | Hand-Schuller-Christian diease |
| Dog or cat bite | Pasteurella multocida |
| Donovan bodies | Granuloma inguinate |
| 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 bones) |
| Edward's 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 tubule reasbsorption 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 pt arms to help legs pick self up off floor) |
| Guillain-Barré syndrome | Idiopathic polyneuritis |
| "Hair-on-end" appearance on x-ray | β-thalassemia, sickle cell anemia (extramedullary hematopoiesis) |
| Hand-Schuller-Christian disease | Chronic progressive histiocytosis |
| HbS | Sickle cell anemia |
| hCG elevated | Choriocarcinoma, hydatiform mole (occurs with and without embryo) |
| Heberden's nodes | Osteoarthritis (DIP swelling 2° to osteoarthritis) |
| Heinz bodies | G6PD deficiency |
| Henoch-Schonlein purpura | Hypersensitivity vasculitis associated with hemorrhagic urticaria and URIs |
| Heterophil antibodies | Infectious Mononucleosis (EBV) |
| HbF | Thalassemia major |
| 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 (autoimmune destruction of β cells) |
| Homer Wright rosettes | Neuroblastoma |
| Honeycomb lung on x-ray | Interstitial fibrosis |
| Horner's syndrome | Ptosis, miosis, and anhydrosis |
| Howell-Jolly bodies | Splenectomy or nonfunctional spleen |
| Huntington's disease | Caudate degeneration (autosomal dominant) |
| Hyperphagia + hypersexuality + hyperorality + hyperdocility | Kluver-Bucy syndrome (amygdala) |
| Hyperpigmentation of the 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 |
| Intussesception | Adenovirus (causes hyperplasia of Peyer's pathches) |
| Janeway lesions | Endocarditis |
| Jarisch-Herxheimer reaction | Syphilis - overaggressive treatment of asymptomatic pt that causes symptoms due to rapid lysis |
| Job's syndrome | Neutrophil chemotaxis abnormality |
| Karposi'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 neuropathy |
| Klüver-Bucy syndrome | Bilateral amygdala lesions |
| Koilocytes | HPV |
| Koplik spots | Measels |
| Krukenberg tumor | Gastric adenocarcinoma with ovarian metastases |
| Kussmaul hyperpnea | Diabetic ketoacidosis (DKA) |
| 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 | Aterial 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 | Poststreptoccocal 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), Waldenstrom'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 lacation 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 sometime 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 defiency]) |
| 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 TB |
| Pseudopalidase 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 |
| 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 |
| Increased Reid index | 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 on 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 |
| Schillar-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 disease |
| "Slapped cheek" | 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 | Postreptoccocal glomerulonephritis |
| Suboccipital lymphadenopathy | Rubella |
| Sulfur granules | Actinomyces israelii |
| 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 |
| 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) |
| Tabes dorsalis | 3° syphilis |
| Tendon xanthomas (classically Achilles) | Familial hypercholesterolemia |
| Thumb sign on lateral x-ray | Epiglottitis (H 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 (blood stasis, endothelial damage, hypercoagulation) |
| von Recklinghausen's disease | Neurofibromatosis with cafe-au-lait spots |
| von Recklinghausen's disease of the 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 1 |
| Whipple's disease | Malabsorption syndrome caused by Tropheryma whippelii |
| Wilson's disease | Hepatolenticular degeneration |
| "Wire loop" appearance on LM | Lupus nephropathy |
| 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 |
Created by:
golfspy
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