Pathognomics USMLE - Step 1 Actinic keratosis Albuminocytologic dissociation Atrophy of mammillary bodies Anti-basement membrane ab Anticentromere ab Anti-double-stranded DNA ab (ANA) Antiepithelial cell Antigliadin ab Antihistone ab Anti-IgG ab Antimitochondrial ab Antineutrophil ab Antiplatelet ab Arachnodactyly Argyll-robertson pupil Aschoff bodies Auer rods Autosplenectomy Babinski sign Baker's cyst in popliteal fossa "Bamboo spine” on x-ray Basophilic stippling of rbes Bence-jones proteins Bilateral hilar adenopathy, uveitis Birbeck granules on em Bloody tap on Ip Blue bloater Blue-domed cysts Blue sclera Boot-shaped heart on x-ray Bouchard's nodes Boutonniere deformit Branching rods in oral infection Brown tumor of bone Brushfield spots Bruton's ANCA p-ANCA Preceeds squamous cell carcinoma Guillan-Barre (incr. Protein in CSF w/ modest iner. In cell count) ‘Wernicke's encephalopathy Goodpasture's Scleroderma (CREST) SLE (Type III hypersensitivity) Pemphigus vulgaris Celiac disease (sprue) Drug-induced SLE Rheumatoid arthritis Primary biliary cirrhosis Vasculitis Idiopathic thrombocytopenic purpura Marfan's syndrome ‘Neurosyphilis Rheumatic fever AML Sickle cell Upper motor neuron lesion Rheumatoid arthritis Ankylosing spondylitis Lead poisoning Multiple myeloma (kappa or lambda Iz light chains in urine), Waldenstroem's macroglobulinemia (IgM) Sarcoidosis Histiocytosis X (eosinophilic granuloma) Subarachnoid hemorhage Chronic bronchitis, Fibrocystic change of the breast Osteogenesis imperfecta Tetralogy of Fallot, RV hypertrophy Osteoarthritis Rheumatoid arthritis Actinomyces israelii Hyperparathyroidism; osteitis fibrosa cystica (von Recklinghausen's disease of bone) Down's syndrome «Pale spots of peripheral iris> Lead poisoning Wegener's granulomatosis Polyarteritis nodosa Neurofibromatosis,if pseudohypertrophy Call-exner bodies Cardiomegaly w/ apical atrophy Cerebriform nuclei Chancre Chancroid Charcot's triad Charcot-leyden crystals cherry-red spot on macula [3] Cheyne-stokes respiration Chocolate eysts Chronic atrophic gastritis Chvostek’s sign ‘Clue cells Codman's triangle on x-ray Cold agglutinins Cold intolerance Condylomata Continuous machinery murmur Cotton-wool spots Cough, conjunctivitis, coryza, fever Councilman bodies Cowdry type a bodies Crescents in howman's capsule Currant-jelly sputum Curschmann's spirals D-dimers Depigmentation of neurons in substantia nigra Dermatitis + dementia + diarrhea Diabetes insipidus + exophtlamos + lesions of skull Dog or cat bite Donovan bodies Elastic skin Duchenne's MD Granulosa/thecal cell tumor of ovary Chagas’ disease > mycosis fungoides (cutaneous T-cell lymphoma) Primary syphillis (NOT painful) Haemophilus ducreyi (PAINFULL) MS (nystagmus, intention tremor, scanning speech), or...cholangitis (jaundice, RUQ pain, fever) Bronchial asthma (eosinophil membranes) Tay-Sachs, Niemann Pick, central retinal artery occlusion Central apnea in CHF and increased ICP Endometriosis (freq. Involve both ovaries) Predisposition to gastric carcinoma Hypocaleemia Gardnerella vaginitis Osteosarcoma Mycoplasma pneumoniae; infectious mononucleosis Myxedema 2' syphilis Patent ductus arteriosus Chronic hypertension Measles Toxic or viral hepatitis Herpesvirus Rapidly progressive crescentic glomerulonephritis Klebsiella Bronchial asthma (whorled mucous plugs) DIC Parkinson's disease (basal gel. Disorder~ rigidity, resting tremor, bradykinesia Pellagra (niacin--vit B3 deficiency) Hand-Schueller-Christian disease Pasteurella multocida Granuloma inguinale Ehlers-Danlos syndromeErythema chronicum migrans Fat+female+fertileforty Fatty liver Ferruginous bodies Ghon focus Gower's maneuver Hair-on-end appearance on x-1 Hampton's hump on x-ray Hbs Heg elevated Heberden's nodes Heinz bodies Heterophil antibodies Hgbf High-output cardiac failure (dilated cardiomyopathy) Hla-b27 [2] Hia-dr3 or -dr4 Homer wright rosettes Honeycomb lung on x-ray Howell-jolly bodies + hypersexuality + Hyperpigmentation of skin Hypersegmented pmns Hypertension + hypokalemia Hypochromatic microcytosis Alpha fetoprotein in amniotic fluid/maternal serum increased Increased uric acid levels [4] Intussuception Janeway lesions Jarisch-herxheimer reaction Kaposi's sarcoma Kayser-fleischer rings Keratin pearls Lyme disease Acute cholecystitis Alcoholism Asbestosis Primary tuberculosis Duchenne’s MD Beta thalassemia Pulmonary embolism Sickle cell anemia Choriocarcinoma (testicular cancer), multiple pregnancy, hyatidiform mole Osteoarthritis < DiP swelling secondary to costeophytes> GOPD deficiency Infectious mononucleosis (EBV) Thalassemia major Wet beri-beri (thiamine--vit B1 deficiency) Reiter's syndrome, ankylosing spondylitis Tidm Neuroblastoma Interstitial fibrosis. Splenectomy or nonfunetional spleen Kluever-Bucy syndrome (amygdala) Primary adrenal insufficiency (Addison's disease Magcrocytic anemia Cushing's & Con's syndromes Iron-deficiency anemia Anencephaly, spina bifida Gout, Lesch-Nyhan syndromes, myeloproliferative disorders, loop and thiazine diuretics Adenovirus (cause hyperplasia of Peyer's patches) Endocarditis Syphilis: overaggressive treatment of an asymptomatic pt. Causing symptoms due to rapid lysis Homosexual AIDS pts, (not assoc'd w/ IVDA-acquired HIV/AIDS) Wilson's disease Squamous cell carcinoma Diabetic nephropathyKoilocytes Koplik spots Kussmaul hyperpnea Lens dislocation + aortic dissection + joint hyperflexibility Lewy bodies Lines of zahn Lisch nodules Low serum ceruloplasmin Lucid interval Lumpy-bumpy appearance of glomeru cai Lytie bone lesions on x-ray Mallory bodies Mcburney's sign MIf syndrome (ino) Monoclonal ab spike [3] Myxedema Necrotizing vasculitis (lungs) & necrotizing glomerulitis Needle-shaped, negatively birefringent crystals Negri bodies Nephritis + cataracts + hearing loss Neurofibrillary tangles No lactation postpartum Nutmeg liver Occupational exposure to asbestos Orphan annie nuclei Osler's nodes Owl's eye Painless jaundice Palpable purpura on legs & buttocks Pannus Periosteal elevation on x-ray Philadelphia chromosome (ber:abl) Human papilloma virus Measles Diabetic ketoacidosis Marfan's syndrome ({ibrillin deficit) Parkinson's disease (basal gel. Disorder— rigidity, resting tremor, bradykinesia Arterial thrombus ‘Neurofibromatosis (von Recklinhausen's) Wilson's disease Epidural hematoma Poststreptococeal glomerulonephri Multiple myeloma Aleoholic liver disease Appendicitis Ms Multiple myeloma (M protein, usu. Igg or IgA), MGUS, Waldenstroem's macroglobulinemia (IgM) Hypothyroidism Wegener's and Goodpasture's (hemoptysis & glomerular disease) Gout Rabies Alport's syndrome Alzheimer's disease Sheehan's syndrome CHF Malignant mesothelioma Papillary carcinoma of the thyroid Subacute endocarditis Cytomegalo virus Pancreatic cancer (head) Henoch-Schoenlein purpura Rheumatoid arthritis infiltration of cornea w/ blood vessels> Pyogenic osteomyelitis CML (occasionally AML. as well)Pick bodies Pink puffer Podagra Podocyte fusion Polyneuropathy preceeded by gi or resp. Infex Polyneuropathy, cardiac pathology, edema Port wine stain Positive anterior drawer sign Pseudopalisade tumor cell arrangement Pseudorosettes Ptosis, miosis, anhidrosis Rash on palms and soles Rbe casts in urine Recurrent pulmonary pseudomonas & s. Aureus infex Red urine in morning Reed-Sternberg cells Rhomboid crystals, positively birefringent Rib notching Roth spots in retina Roleaux formation Russell bodies S3 S4 Schwartzman reacti Schiller-duval bodies Senile plaques Signet ring cel Simian crease Skip lesions Slapped cheeks Smith antigen Smudge cell Soap bubble on x-ray Spike & dome on em of kidney tissue Spitz nevus inter hemorrhages in fingernail Pick's disease Emphysema (centroacinar [smoking], panacinar [alpha-1 antitrypsin def.]) Gout (MP joint of hallux) Minimal change disease Guillan-barre Dry beri-beri (thiamine, BI def.) Hemangioma ACL injury Glioblastoma multiforme Ewing's sarcoma Horner's syndrome (Pancoast’s tumor) Secondary syphillis, Rocky Mountain spotted fever Acute glomerulonephritis Cystie fibrosis Paroxysmal nocturnal hemoglobinuria Hodgkin's lymphoma Chronic bronchitis. Leydig cell tumor Von Hippel-Lindau disease Acute toxic/viral nephrosis Pseudogout Coaretation of aorta Endocarditis Multiple myeloma Multiple myeloma Left-to-right shunt (VSD, PDA, ASD), mitral regurg., LV failure (CHF) Aortie stenosis, hypertrophic subaortic stenosis N. Meningitidis Yolk sac tumor Alzheimer's disease Gastrie carcinoma Down's syndrome Crohn's Erythema infectiosum (fifth disease) SLE cll Giant cell tumor of bone Membranous glomerulonephritis Benign juvenile melanoma EndocarditisStarry-sky pattern "Strawberry tongue” Streaky ovaries String sign on x-ray Subepithelial humps on em of kidney tissue Suboccipital lymphadenopathy Sulfur granules Swollen gums, bruising, poor wound healing, anemia Systolic ejection murmur (crescendo- decrescendo) (8:14) 1(9:22) (14:18) Tabes dorsalis ‘Tendon xanthomas (classically achilles) ‘Thumb sign on lateral x-ray ation of kidney appearance on Im Trousseau's sign Virchow's node Virchow's node Von recklinghausen's disease Von recklinghausen's disease of bone Wallenberg's syndrome Waterhouse-friderichsen syndrome Wary casts Whe casts in urine Wbes in urine Wermer's syndrome Whipple's disease Wilson's disease "Wire loop" appearance on Im "Worst headache of my life" Xanthochromia (esf) ‘Xerostomia + arthritis + Keratoconjunt Sieca Zenker's diverticulum Burkitt’ lymphoma Scarlet fever Turner's syndrome Crohn's disease Poststreptococeal glomerulonephritis Rubella Actinomyces israelii Scurvy (ascorbic acid, vitamin C deficiency) - vit. C is necessary for hydroxylation of proline and lysine in collagen synthesis Aortic valve stenosis Burkitt's lymphoma (c-myc activation) Philadelphia chromosome, CML (ber-abl hybrid) Follicular lymphomas (bel-2 activation) Tertiary symphilis Familial hypercholesterolemia Epiglotitis (Haemophilus influenzae) Chronic bacterial pyelonephritis Gout Membranoproliferative glomerulonephritis Visceral cancer, pancreatic adenocarcinoma (migratory thrombophlebitis), hypocalcemia (carpal spasm) Left supraclavicular node enlargement from metastatic carcinoma of the stomach Pulmonary embolism (triad = blood stasis, endothelial damage, hypercoagulation) Neurofibromatosis with café-au-lait spots Osteitis fibrosa cystica ("brown tumor") PICA thrombosis Adrenal hemorrhage associated with meningococcemia Chronic end-stage renal disease Acute pyelonephritis Acute cystitis MEN type I Malabsorption syndrome caused by ‘Tropheryma whippelii Hepatolenticular degeneration > Lupus nephropathy Berry aneurysm - associated with adult polycystic kidney disease Subarachnoid hemorrhage Sjogren's syndrome > Upper Gl diverticulumZollinger-ellison syndrome Deletion on chromosome 13 Thrombocytopenia & eczema & recurrent infex ‘Tree-bark calcification of aorta Psammoma bodies S-hydroxyindoleacetic aci Bronze diabetes Benzene Dry tap Cut potato lymph nodes Most common cause of death in cystic fibrosis Klinefelter's karyo- & phenotype Ca-125 elevated +5100 antigen, -mucin Pancoast tumor Hie gene defect, chromosome 6 Deficient activity of NADPH o: Hla-dr5 & hla-bS Sp Anti-sel-70 Anti-ss-b Anti-nrnp Elevated alpha-fetoprotein Loss of GTPase (14318) T(S317 N-mye amplification Familial p-53 mutation Ret mutation Aflatoxin b1 causes B-napthylamine causes Mc cause of viral pharyngitis Down's syndrome heart disease ‘Turner's syndrome heart disease Order of mi enzymes Sydenham chorea Death from acute respiratory failure Cyanosis in congenital heart disease Abnormal schilling test Increased a2 hemoglobin Low serum Fe with low TIBC Pizz allele Gastrin-secreting tumor associated with ulcers Retinoblastoma Wiskott-Aldrich syndrome Syphilitic aortitis (3') 1- papillary carcinoma of thyroid or ovary 2- meningioma 3- malignant mesothelioma Careinoid syndrome Hemochromatosis. Aplastic anemia Myelofibrosis Non-Hodgkins lymphoma Pseudomonas infex XXY, male eunuch Ovarian cancer Vulvar malignant melanoma Apical lung tumor compressing cervical sympathetic plexus, causing Horner's syndrome Hereditary hemochromatosis Chronic granulomatous disease of childhood Hashimoto thyroiditis Cri du chat Scleroderma Sjogren's Mixed connective tissue disease Hepatocellular carcinoma Ras mutation Follicular lymphoma (bel-2) Acute promyleocytic leukemia ‘Neuroblastoma Li fraumeni syndrome MEN Tla Hepatocellular carcinoma Bladder cancer Adenovirus Cushion defects Coareted aorta (Ck-mb & trop-i AST dh Rheumatic fever Myocarditis Right to left shunt Pernicious anemia B thalassemia minor Anemia of chronic disease Homozygous defect in al-antitrypsinLemon-yellow skin Absence of serum haptoglobins Increased hemoglobin f Positive ham test Schistocytes Spherocytes w/ negative coomb's test Spherocytes w/ positive coomb's test Postive t.r.a.p. Test Erythrocytosis w/ low erythropo ‘Tear-drop erythrocytes T(11;14) Anergy to skin test ag Q fever Low glucuronyl transferase Anti-smooth muscle ab Fatty food intolerance Saber shin Spindle-shaped cells w/ herringbone pattern T(11;22)(q24;12) translocation Spike & dome Smoky brown urine Bun:creatinine > 15 Precocious male puberty Precocious female puberty Mc urinary tract tumor Increased total psa, decreased % free psa Increased total psa, no change in % free psa Complete hydatidiform mole karyotype Hia-dr3 & hla-b8 Plummer disease Increased pth, hypercalcemia Increased pth, hypocalcemia Short 4th or Sth metacarpals & metatarsals Buffalo hump 21-hydroxylase deficiency 11-hydroxylase deficiency "Target" lesion Accanthosis nigricans ‘Small blue cell bone tumor Blue sclera Me site of cerebrovascular thrombosis/embolism secretion, predisposing to panacinar ‘emphysema Pernicious anemia Hemolytic anemia B thalassemia major Paroxysmal nocturnal hemoglobinuria TIP Hereditary spherocytosis Waha Hairy cell leukemia Polyeytemia vera Chronic idiopathic myelofibrosis Mantle cell lymphoma Sarcoidosis Rickettsial pneumonia from unpasteurized milk Crigler-Najar, Gilbert syndromes (liver enzyme conjugating billirubin) ‘Autoimmune hepatitis Cholelithiasis Skeletal syphillis Fibrosarcoma Ewing sarcoma (malignant round cell tumor of bone) Membranous glomerulonephritis (a nephrotic synd) Nephritis syndrome Prerenal azotemia Leydig cell tumor Granulosa cell tumor Transitional cell Prostatic carcinoma Bph 46XX, but all paternal Increased risk of Grave's disease Grave's, without the exophthalmos Parathyroid adenoma Renal disease Pseudohypoparathyroidism (AR) Hypercortisolism (Cushing's) Virilism w/ salt loss and hypotension Virilism w/ salt retention and HTN Erythema multiforme Visceral malignancy Ewing sarcoma Osteogenesis imperfecta Middle cerebral aMaternal folic acid deficiency Fetal neural tube defects Me cause of intracerebral hemorrhage Hin Mesite of intracerebral hemorrhage Basal gel & thalamus