USMLE First Aid Classic Findings

1. Actinic keratosis: Often precedes squamous cell carcinoma 2. Addisons disease: 1 adrenocortical deficiency 3. Albrights syndrome: Polyostotic fibrous dysplasia, precocious puberty, caf-au-lait spots, short stature, young girls 4. Albuminocytologic dissociation: Guillain-Barr ( protein in CSF with only modest in cell count) 5. Alports syndrome: Hereditary nephritis with nerve deafness 6. Anti-double-stranded DNA antibodies (ANA antibodies): SLE (type III hypersensitivity) 7. Anti-IgG antibodies: Rheumatoid arthritis 8. Antibasement membrane antibodies: Goodpastures syndrome 9. Antiepithelial cell antibodies: Pemphigus vulgaris 10. Anticentromere antibodies: Scleroderma (CREST) 11. Antigliadin antibodies: Celiac disease 12. Antihistone antibodies: Drug-induced SLE 13. Antimitochondrial antibodies: 1 biliary cirrhosis 14. Antineutrophil antibodies: Vasculitis 15. Antiplatelet antibodies: Idiopathic thrombocytopenic purpura 16. Arachnodactyly: Marfans syndrome 17. Argyll Robertson pupil: Neurosyphilis 18. Arnold-Chiari malformation: Cerebellar tonsillar herniation 19. Aschoff bodies: Rheumatic fever 20. Atrophy of the mammillary bodies: Wernickes encephalopathy 21. Auer rods: Acute myelogenous leukemia (especially the promyelocytic type) 22. Autosplenectomy: Sickle cell anemia 23. Bamboo spine on x-ray: Ankylosing spondylitis 24. Blue bloater: Chronic bronchitis 25. Brown tumor of bone: Hemorrhage causes brown color of osteolytic cysts: 1. Hyperparathyroidism 2. Osteitis fibrosa cystica (von Recklinghausens disease) 26. Chocolate cysts: Endometriosis (frequently involves both ovaries) 27. Fat, female, forty, and fertile: Acute cholecystitis 28. Hair-on-end appearance on x-ray: -thalassemia, sickle cell anemia (extramedullary hematopoiesis) 29. Lumpy-bumpy appearance of glomeruli on immunofluorescence: Poststreptococcal glomerulonephritis 30. Orphan Annie nuclei: Papillary carcinoma of the thyroid 31. Pink puffer: Emphysema (centroacinar [smoking], panacinar [1-antitrypsin deficiency]) 32. Smudge cell: CLL 33. Strawberry tongue: Scarlet fever 34. Tram-track appearance on LM: Membranoproliferative glomerulonephritis 35. Wire loop appearance on LM: Lupus nephropathy 36. Worst headache of my life: Berry aneurysmassociated with adult polycystic kidney disease 37. Babinskis sign: UMN lesion 38. Bakers cyst in popliteal fossa: Rheumatoid arthritis 39. Bartters syndrome: Hyperreninemia 40. Basophilic stippling of RBCs: Lead poisoning

41. Beckers muscular dystrophy: Defective dystrophin; less severe than Duchennes 42. Bells palsy: LMN CN VII palsy 43. Bence Jones proteins: Multiple myeloma (kappa or lambda Ig light chains in urine), Waldenstrms macroglobulinemia (IgM) 44. Bernard-Soulier disease: Defect in platelet adhesion 45. Bilateral hilar adenopathy, uveitis: Sarcoidosis 46. Birbeck granules on EM: Histiocytosis X (eosinophilic granuloma) 47. Bloody tap on LP: Subarachnoid hemorrhage 48. Blue sclera: Osteogenesis imperfecta 49. Blue-domed cysts: Fibrocystic change of the breast 50. Boot-shaped heart on x-ray: Tetralogy of Fallot; RVH 51. Bouchards nodes: Osteoarthritis (PIP swelling 2 to osteophytes) 52. Boutonnire deformity: Rheumatoid arthritis 53. Branching rods in oral infection: Actinomyces israelii 54. Brushfields spots: Down syndrome 55. Brutons disease: X-linked agammaglobulinemia 56. Budd-Chiari syndrome: Posthepatic venous thrombosis 57. Buergers disease: Small/medium-artery vasculitis 58. Burkitts lymphoma: 8:14 translocation; associated with EBV 59. Burtons lines: Lead poisoning 60. C-ANCA, P-ANCA: Wegeners granulomatosis, polyarteritis nodosa 61. Caf-au-lait spots on skin: Neurofibromatosis 62. Caisson disease: Gas emboli 63. Calf pseudohypertrophy: Duchennes muscular dystrophy

64. Call-Exner bodies: Granulosa-theca cell tumor of the ovary 65. Cardiomegaly with apical atrophy: Chagas disease 66. Cerebriform nuclei: Mycosis fungoides (cutaneous T-cell lymphoma) 67. Chagas disease: Trypanosome infection 68. Chancre: 1 syphilis (not painful) 69. Chancroid: Haemophilus ducreyi (painful) 70. Charcot-Leyden crystals: Bronchial asthma (eosinophil membranes) 71. Charcots triad: Multiple sclerosis (nystagmus, intention tremor, scanning speech), cholangitis (jaundice, RUQ pain, fever) 72. Chdiak-Higashi disease: Phagocyte deficiency 73. Cheyne-Stokes respirations: Central apnea in CHF and intracranial pressure 74. Chronic atrophic gastritis: Predisposition to gastric carcinoma 75. Chvosteks sign: Hypocalcemia (facial muscle spasm upon tapping) 76. Clear cell adenocarcinoma of: DES exposure in utero 77. Clue cells: Gardnerella vaginitis 78. Codmans triangle on x-ray: Osteosarcoma 79. Cold agglutinins: Mycoplasma pneumoniae, infectious mononucleosis 80. Cold intolerance: Hypothyroidism 81. Condylomata lata: 2 syphilis 82. Continuous machinery murmur: Patent ductus arteriosus 83. Coris disease: Debranching enzyme deficiency 84. Cotton-wool spots: Chronic hypertension 85. Cough, conjunctivitis, coryza: Measles 86. Councilman bodies: Toxic or viral hepatitis 87. Cowdry type A bodies: Herpesvirus 88. Crescents in Bowmans capsule: Rapidly progressive crescentic glomerulonephritis

89. Crigler-Najjar syndrome: Congenital unconjugated hyperbilirubinemia

112. Gauchers disease: Glucocerebrosidase deficiency

113. Ghon focus: 1 TB 90. Curlings ulcer: Acute gastric ulcer associated with severe 114. Gilberts syndrome: Benign congenital unconjugated burns hyperbilirubinemia 91. Currant-jelly sputum: Klebsiella 115. Glanzmanns thrombasthenia: Defect in platelet aggregation 92. Curschmanns spirals: Bronchial asthma (whorled mucous plugs) 116. Goodpastures syndrome: Autoantibodies against alveolar and glomerular basement membrane proteins 93. Cushings ulcer: Acute gastric ulcer associated with CNS injury 117. Gowers maneuver: Duchennes (use of patients arms to help legs pick self off the floor) 94. D-dimers: DIC 95. Depigmentation of neurons in: Parkinsons disease (basal 118. Guillain-Barr syndrome: Idiopathic polyneuritis ganglia disorderrigidity, resting tremor, 119. Hand-Schller-Christian disease: Chronic progressive bradykinesia) histiocytosis 96. Dermatitis, dementia, diarrhea: Pellagra (niacin, vitamin 120. HbF: Thalassemia major B3 deficiency) 121. HbS: Sickle cell anemia 97. Diabetes insipidus + exophthalmos +: 122. hCG elevated: Choriocarcinoma, hydatidiform mole Hand-Schller-Christian disease (occurs with and without embryo) 98. Dog or cat bite: Pasteurella multocida 123. Heberdens nodes: Osteoarthritis (DIP swelling 2 to 99. Donovan bodies: Granuloma inguinale osteophytes) 100. Dresslers syndrome: Post-MI fibrinous pericarditis 124. Heinz bodies: G6PD deficiency 101. Duchennes muscular dystrophy: Deleted dystrophin gene (X-linked recessive) 102. Eburnation: Osteoarthritis (polished, ivory-like appearance of bone) 103. Edwards syndrome: Trisomy 18 associated with rocker-bottom feet, low-set ears, heart disease 125. Henoch-Schnlein purpura: Hypersensitivity vasculitis associated with hemorrhagic urticaria and URIs 126. Heterophil antibodies: Infectious mononucleosis (EBV) 127. High-output cardiac failure (dilated cardiomyopathy): Wet beriberi (thiamine, vitamin B1 deficiency) HLA-B27: Reiters syndrome, ankylosing spondylitis HLA-DR3 or -DR4: Diabetes mellitus type 1 (caused by autoimmune destruction of cells) Homer Wright rosettes: Neuroblastoma Honeycomb lung on x-ray: Interstitial fibrosis Howell-Jolly bodies: Splenectomy (or nonfunctional spleen)

128. 104. Eisenmengers complex: Late cyanosis shunt (uncorrected 129. L R shunt becomes R L shunt) 105. Elastic skin: Ehlers-Danlos syndrome 130. 106. Erb-Duchenne palsy: Superior trunk brachial plexus 131. injury (waiters tip) 132. 107. Erythema chronicum migrans: Lyme disease 108. Fanconis syndrome: Proximal tubular reabsorption defect 109. Fatty liver: Alcoholism 110. Ferruginous bodies: Asbestosis 111. Gardners syndrome: Colon polyps with osteomas and soft tissue tumors

133. Huntingtons disease: Caudate degeneration (autosomal dominant) 134. Hyperphagia + hypersexuality + hyperorality + hyperdocility: Klver-Bucy syndrome (amygdala) 135. Hyperpigmentation of skin: 1 adrenal insufficiency (Addisons disease) 136. Hypersegmented neutrophils: Macrocytic anemia 137. Hypertension + hypokalemia: Conns syndrome 138. Hypochromic microcytosis: Iron deficiency anemia, lead poisoning 139. Increased -fetoprotein in amniotic fluid/maternal serum: Anencephaly, spina bifida (neural tube defects) 140. Increased uric acid levels: Gout, Lesch-Nyhan syndrome, myeloproliferative disorders, loop and thiazide diuretics 141. Intussusception: Adenovirus (causes hyperplasia of Peyers patches) 142. Bergers disease: IgA nephropathy 143. Cherry-red spot on macula: Tay-Sachs, Niemann-Pick disease, central retinal artery occlusion 144. Dubin-Johnson syndrome: Congenital conjugated hyperbilirubinemia (black liver) 145. Horners syndrome: Ptosis, miosis, and anhidrosis 146. Low serum ceruloplasmin: Wilsons disease 147. Philadelphia chromosome (bcr-abl ): CML (may sometimes be associated with AML) 148. Rib notching: Coarctation of aorta 149. t(8;14): Burkitts lymphoma (c-myc activation) 150. Janeway lesions: Endocarditis 151. Jarisch-Herxheimer reaction: Syphilisoveraggressive treatment of an asymptomatic patient that causes symptoms due to rapid lysis 152. Jobs syndrome: Neutrophil chemotaxis abnormality

153. Kaposis sarcoma: AIDS in MSM (men who have sex with men) 154. Kartageners syndrome: Dynein defect 155. Kayser-Fleischer rings: Wilsons disease 156. Keratin pearls: Squamous cell carcinoma 157. Kimmelstiel-Wilson nodules: Diabetic nephropathy 158. Klver-Bucy syndrome: Bilateral amygdala lesions 159. Koilocytes: HPV 160. Koplik spots: Measles 161. Krukenberg tumor: Gastric adenocarcinoma with ovarian metastases 162. Kussmaul hyperpnea: Diabetic ketoacidosis 163. Lens dislocation + aortic dissection + joint hyperflexibility: Marfans syndrome (fibrillin deficit) 164. Lesch-Nyhan syndrome: HGPRT deficiency 165. Lewy bodies: Parkinsons disease 166. Libman-Sacks disease: Endocarditis associated with SLE 167. Lines of Zahn: Arterial thrombus 168. Lisch nodules: Neurofibromatosis (von Recklinghausens disease) 169. Lucid interval: Epidural hematoma 170. Lytic bone lesions on x-ray: Multiple myeloma 171. Mallory bodies: Alcoholic liver disease 172. Mallory-Weiss syndrome: Esophagogastric lacerations 173. McArdles disease: Muscle phosphorylase deficiency 174. McBurneys sign: Appendicitis 175. MLF syndrome (INO): Multiple sclerosis 176. Monoclonal antibody spike: Multiple myeloma (called the M protein; usually IgG or IgA), MGUS (monoclonal gammopathy of undetermined significance), Waldenstrms (M protein = IgM) macroglobulinemia 177. Myxedema: Hypothyroidism

178. Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis: Wegeners and Goodpastures (hemoptysis and glomerular disease) 179. Needle-shaped, negatively birefringent crystals: Gout 180. Negri bodies: Rabies 181. Nephritis + cataracts + hearing loss: Alports syndrome 182. Neurofibrillary tangles: Alzheimers disease 183. Niemann-Pick disease: Sphingomyelinase deficiency 184. No lactation postpartum: Sheehans syndrome (pituitary infarction) 185. Nutmeg liver: CHF 186. Occupational exposure to asbestos: Malignant mesothelioma 187. Oslers nodes: Endocarditis 188. Owls eye: CMV 189. Painless jaundice: Pancreatic cancer (head) 190. Palpable purpura on legs and buttocks: Henoch-Schnlein purpura 191. Pancoasts tumor: Bronchogenic apical tumor associated with Horners syndrome 192. Pannus: Rheumatoid arthritis 193. Parkinsons disease: Nigrostriatal dopamine depletion 194. Periosteal elevation on x-ray: Pyogenic osteomyelitis 195. Peutz-Jeghers syndrome: Benign polyposis 196. Peyronies disease: Penile fibrosis 197. Pick bodies: Picks disease 198. Picks disease: Progressive dementia, similar to Alzheimers 199. Plummer-Vinson syndrome: Esophageal webs with iron deficiency anemia 200. Podagra: Gout (MP joint of hallux) 201. Podocyte fusion: Minimal change disease 202. Polyneuropathy preceded by GI or respiratory infection: Guillain-Barr syndrome

203. Polyneuropathy, cardiac pathology, and edema: Dry beriberi (thiamine, vitamin B1 deficiency) 204. Pompes disease: Lysosomal glucosidase deficiency associated with cardiomegaly 205. Port-wine stain: Hemangioma 206. Positive anterior drawer sign: Anterior cruciate ligament injury 207. Potts disease: Vertebral tuberculosis 208. Pseudopalisade tumor cell arrangement: Glioblastoma multiforme 209. Pseudorosettes: Ewings sarcoma 210. Ptosis, miosis, anhidrosis: Horners syndrome (Pancoasts tumor) 211. Rash on palms and soles: 2 syphilis, Rocky Mountain spotted fever 212. Raynauds syndrome: Recurrent vasospasm in extremities 213. RBC casts in urine: Acute glomerulonephritis 214. Recurrent pulmonary Pseudomonas and S. aureus infections: Cystic fibrosis 215. Red urine in the morning: Paroxysmal nocturnal hemoglobinuria 216. Reed-Sternberg cells: Hodgkins lymphoma 217. Reid index (increased): Chronic bronchitis 218. Reinke crystals: Leydig cell tumor 219. Reiters syndrome: Urethritis, conjunctivitis, arthritis 220. Renal cell carcinoma + cavernous hemangiomas + adenomas: von HippelLindau disease 221. Renal epithelial casts in urine: Acute toxic/viral nephrosis 222. Rhomboid crystals, positively birefringent: Pseudogout 223. Roths spots in retina: Endocarditis 224. Rotors syndrome: Congenital conjugated hyperbilirubinemia 225. Rouleaux formation (RBCs): Multiple myeloma 226. Russell bodies: Multiple myeloma

227. S3: Left-to-right shunt (VSD, PDA, ASD), mitral regurgitation, LV failure (CHF) 228. S4: Aortic stenosis, hypertrophic subaortic stenosis 229. Szary syndrome: Cutaneous T-cell lymphoma 230. Schiller-Duval bodies: Yolk sac tumor 231. Senile plaques: Alzheimers disease 232. Sheehans syndrome: Postpartum pituitary necrosis 233. Shwartzman reaction: Neisseria meningitidis 234. Signet-ring cells: Gastric carcinoma 235. Simian crease: Down syndrome 236. Sipples syndrome: MEN type IIa 237. Sjgrens syndrome: Dry eyes, dry mouth, arthritis 238. Skip lesions: Crohns 239. Slapped cheeks: Erythema infectiosum (fifth disease) 240. Smith antigen: SLE 241. Soap bubble on x-ray: Giant cell tumor of bone 242. Spike and dome on EM: Membranous glomerulonephritis 243. Spitz nevus: Benign juvenile melanoma 244. Splinter hemorrhages in fingernails: Endocarditis 245. Starry-sky pattern: Burkitts lymphoma 246. Streaky ovaries: Turners syndrome 247. String sign on x-ray: Crohns disease 248. Subepithelial humps on EM: Poststreptococcal glomerulonephritis 249. Suboccipital lymphadenopathy: Rubella 250. Sulfur granules: Actinomyces israelii

253. t(14;18): Follicular lymphomas (bcl-2 activation) 254. t(9;22): Philadelphia chromosome, CML (bcr-abl hybrid) 255. Tabes dorsalis: 3 syphilis 256. Tendon xanthomas (classically Achilles): Familial hypercholesterolemia 257. Thumb sign on lateral x-ray: Epiglottitis (Haemophilus influenzae) 258. Thyroidization of kidney: Chronic bacterial pyelonephritis 259. Tophi: Gout 260. Trousseaus sign: Visceral cancer, pancreatic adenocarcinoma (migratory thrombophlebitis), hypocalcemia (carpal spasm) 261. Virchows node: Left supraclavicular node enlargement from metastatic carcinoma of the stomach 262. Virchows triad: Pulmonary embolism (triad = blood stasis, endothelial damage, hypercoagulation) 263. von Recklinghausens disease: Neurofibromatosis with caf-au-lait spots 264. von Recklinghausens disease of bone: Osteitis fibrosa cystica (brown tumor) 265. Wallenbergs syndrome: PICA thrombosis 266. Waterhouse-Friderichsen syndrome: Adrenal hemorrhage associated with meningococcemia 267. Waxy casts: Chronic end-stage renal disease 268. WBC casts in urine: Acute pyelonephritis 269. WBCs in urine: Acute cystitis 270. Wermers syndrome: MEN type I

251. Swollen gums, bruising, poor wound healing, anemia: 271. Whipples disease: Malabsorption syndrome caused by Scurvy (ascorbic acid, vitamin C deficiency)vitamin C Tropheryma whippelii is necessary for hydroxylation of proline and lysine in 272. Wilsons disease: Hepatolenticular degeneration collagen synthesis 273. Xanthochromia (CSF): Subarachnoid hemorrhage 252. Systolic ejection murmur (crescendo-decrescendo): 274. Xerostomia + arthritis + keratoconjunctivitis sicca: Aortic valve stenosis Sjgrens syndrome

275. Zenkers diverticulum: Upper GI diverticulum 276. Zollinger-Ellison syndrome: Gastrin-secreting tumor associated with ulcers