USMLE First Aid Classic Findings

1. Actinic keratosis: Often precedes squamous cell

carcinoma

22. Autosplenectomy: Sickle cell anemia

23. Bamboo spine on x-ray: Ankylosing spondylitis

2. Addisons disease: 1 adrenocortical deficiency

3. Albrights syndrome: Polyostotic fibrous dysplasia,
precocious puberty, caf-au-lait spots, short stature,
young girls

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)

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

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

10. Anticentromere antibodies: Scleroderma (CREST)

11. Antigliadin antibodies: Celiac disease

31. Pink puffer: Emphysema (centroacinar [smoking],

panacinar [1-antitrypsin deficiency])

12. Antihistone antibodies: Drug-induced SLE

13. Antimitochondrial antibodies: 1 biliary cirrhosis

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

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

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

21. Auer rods: Acute myelogenous leukemia (especially the

promyelocytic type)

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)

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

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)

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

203. Polyneuropathy, cardiac pathology, and edema: Dry

beriberi (thiamine, vitamin B1 deficiency)
204. Pompes disease: Lysosomal glucosidase deficiency
associated with cardiomegaly

180. Negri bodies: Rabies

181. Nephritis + cataracts + hearing loss: Alports syndrome

205. Port-wine stain: Hemangioma

206. Positive anterior drawer sign: Anterior cruciate
ligament injury

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

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