usmle pathognomics
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Pathognomics USMLEStep1
Actinic keratosis Preceeds squamous cell carcinoma
Albuminocytologic dissociation Guillan-Barre (incr. Protein in CSF w/
modest incr. In cell count)Atrophy of mammillary bodies Wernicke's encephalopathy
Anti-basement membrane ab Goodpasture's
Anticentromere ab Scleroderma (CREST)
Anti-double-stranded DNA ab (ANA) SLE (Type III hypersensitivity)
Antiepithelial cell Pemphigus vulgarisAntigliadin ab Celiac disease (sprue)
Antihistone ab Drug-induced SLE
Anti-IgG ab Rheumatoid arthritis
Antimitochondrial ab Primary biliary cirrhosis
Antineutrophil ab Vasculitis
Antiplatelet ab Idiopathic thrombocytopenic purpuraArachnodactyly Marfan's syndrome
Argyll-robertson pupil Neurosyphilis
Aschoff bodies Rheumatic fever
Auer rods AMLAutosplenectomy Sickle cell
Babinski sign Upper motor neuron lesion
Baker's cyst in popliteal fossa Rheumatoid arthritis
"Bamboo spine" on x-ray Ankylosing spondylitis
Basophilic stippling of rbcs Lead poisoningBence-jones proteins Multiple myeloma (kappa or lambda Ig
light chains in urine), Waldenstroem's
macroglobulinemia (IgM)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 Tetralogy of Fallot; RV hypertrophyBouchard's nodes Osteoarthritis
Boutonniere deformity Rheumatoid arthritis
Branching rods in oral infection Actinomyces israelii
Brown tumor of bone Hyperparathyroidism; osteitis fibrosa
cystica (von Recklinghausen's disease of
bone)
Brushfield spots Down's syndrome
Bruton's lines Lead poisoningc-ANCA Wegener's granulomatosis
p-ANCA Polyarteritis nodosaCaf-au-lait spots Neurofibromatosis
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Calf pseudohypertrophy Duchenne's MD
Call-exner bodies Granulosa/thecal cell tumor of
ovary
Cardiomegaly w/ apical atrophy Chagas' disease
Cerebriform nuclei > mycosis fungoides (cutaneous T-celllymphoma)
Chancre Primary syphillis (NOT painful)
Chancroid Haemophilus ducreyi (PAINFULL)Charcot's triad MS (nystagmus, intention tremor, scanning
speech),
orcholangitis (jaundice, RUQ pain,
fever)
Charcot-leyden crystals Bronchial asthma (eosinophil membranes)
Cherry-red spot on macula [3] Tay-Sachs, Niemann Pick, central retinal
artery occlusionCheyne-stokes respiration Central apnea in CHF and increased ICP
Chocolate cysts Endometriosis (freq. Involve both ovaries)Chronic atrophic gastritis Predisposition to gastric carcinoma
Chvostek's sign Hypocalcemia
Clue cells Gardnerella vaginitis
Codman's triangle on x-ray Osteosarcoma
Cold agglutinins Mycoplasma pneumoniae; infectiousmononucleosis
Cold intolerance MyxedemaCondylomata 2' syphilis
Continuous machinery murmur Patent ductus arteriosus
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
Currant-jelly sputum Klebsiella
Curschmann's spirals Bronchial asthma (whorled mucous plugs)D-dimers DIC
Depigmentation of neurons in substantia
nigra
Parkinson's disease (basal ggl. Disorder--
rigidity, resting tremor, bradykinesia
Dermatitis + dementia + diarrhea Pellagra (niacin--vit B3 deficiency)
Diabetes insipidus + exophtlamos +
lesions of skull
Hand-Schueller-Christian disease< a form of histiocytosis >
Dog or cat bite Pasteurella multocidaDonovan bodies Granuloma inguinale
Elastic skin Ehlers-Danlos syndrome
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Erythema chronicum migrans Lyme disease
Fat+female+fertile+forty Acute cholecystitis
Fatty liver Alcoholism
Ferruginous bodies Asbestosis
Ghon focus Primary tuberculosis
Gower's maneuver Duchenne's MDHair-on-end appearance on x-ray Beta thalassemia
Hampton's hump on x-ray Pulmonary embolismHbs Sickle cell anemia
Hcg elevated Choriocarcinoma (testicular cancer),
multiple pregnancy, hyatidiform mole
Heberden's nodes Osteoarthritis < DIP swelling secondary to
osteophytes>
Heinz bodies G6PD deficiency < refractile granules in
rbcs>Heterophil antibodies Infectious mononucleosis (EBV)
Hgb f Thalassemia major
High-output cardiac failure (dilatedcardiomyopathy)
Wet beri-beri (thiamine--vit B1 deficiency)
Hla-b27 [2] Reiter's syndrome, ankylosing spondylitis
Hla-dr3 or -dr4 T1dm
Homer wright rosettes Neuroblastoma
Honeycomb lung on x-ray Interstitial fibrosis
Howell-jolly bodies Splenectomy or nonfunctional spleen
Hyperphagia + hypersexuality +
hyperorality + hyperdocility
Kluever-Bucy syndrome (amygdala)
Hyperpigmentation of skin Primary adrenal insufficiency (Addison's
disease
Hypersegmented pmns Macrocytic anemia
Hypertension + hypokalemia Cushing's & Conn's syndromes
Hypochromatic microcytosis Iron-deficiency anemia
Alpha fetoprotein in amniotic
fluid/maternal serum increased
Anencephaly, spina bifida
Increased uric acid levels [4] Gout, Lesch-Nyhan syndromes,
myeloproliferative disorders, loop and
thiazine diuretics
Intussuception Adenovirus (cause hyperplasia of Peyer's
patches)Janeway lesions Endocarditis
Jarisch-herxheimer reaction Syphilis: overaggressive treatment of an
asymptomatic pt. Causing symptoms due torapid lysis
Kaposi's sarcoma Homosexual AIDS pts. (not assoc'd w/
IVDA-acquired HIV/AIDS)
Kayser-fleischer rings Wilson's disease
Keratin pearls Squamous cell carcinomaKimmelstiel-wilson nodules Diabetic nephropathy
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Koilocytes Human papilloma virus
Koplik spots Measles
Kussmaul hyperpnea Diabetic ketoacidosis
Lens dislocation + aortic dissection +
joint hyperflexibility
Marfan's syndrome (fibrillin deficit)
Lewy bodies Parkinson's disease (basal ggl. Disorder--
rigidity, resting tremor, bradykinesiaLines of zahn Arterial thrombus
Lisch nodules Neurofibromatosis (von Recklinhausen's)
Low serum ceruloplasmin Wilson's disease
Lucid interval Epidural hematomaLumpy-bumpy appearance of glomeruli
on if
Poststreptococcal glomerulonephritis
Lytic bone lesions on x-ray Multiple myeloma
Mallory bodies Alcoholic liver disease
Mcburney's sign Appendicitis
Mlf syndrome (ino) Ms
Monoclonal ab spike [3] Multiple myeloma (M protein, usu. Igg orIgA), MGUS, Waldenstroem's
macroglobulinemia (IgM)Myxedema Hypothyroidism
Necrotizing vasculitis (lungs) &
necrotizing glomerulitis
Wegener's and Goodpasture's (hemoptysis
& glomerular disease)
Needle-shaped, negatively birefringent
crystals
Gout
Negri bodies Rabies
Nephritis + cataracts + hearing loss Alport's syndromeNeurofibrillary tangles Alzheimer's disease
No lactation postpartum Sheehan's syndromeNutmeg liver CHF
Occupational exposure to asbestos Malignant mesothelioma
Orphan annie nuclei Papillary carcinoma of the thyroidOsler's nodes Subacute endocarditis
Owl's eye Cytomegalo virus
Painless jaundice Pancreatic cancer (head)Palpable purpura on legs & buttocks Henoch-Schoenlein purpura
Pannus Rheumatoid arthritis
Periosteal elevation on x-ray Pyogenic osteomyelitisPhiladelphia chromosome (bcr:abl) CML (occasionally AML, as well)
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Pick bodies Pick's disease
Pink puffer Emphysema (centroacinar [smoking],
panacinar [alpha-1 antitrypsin def.])
Podagra Gout (MP joint of hallux)
Podocyte fusion Minimal change disease
Polyneuropathy preceeded by gi or resp.
Infex
Guillan-barre
Polyneuropathy, cardiac pathology,
edema
Dry beri-beri (thiamine, B1 def.)
Port wine stain Hemangioma
Positive anterior drawer sign ACL injury
Pseudopalisade tumor cell arrangement Glioblastoma multiforme
Pseudorosettes Ewing's sarcoma
Ptosis, miosis, anhidrosis Horner's syndrome (Pancoast's tumor)
Rash on palms and soles Secondary syphillis, Rocky Mountain
spotted feverRbc casts in urine Acute glomerulonephritis
Recurrent pulmonary pseudomonas & s.
Aureus infex
Cystic fibrosis
Red urine in morning Paroxysmal nocturnal hemoglobinuriaReed-Sternberg cells Hodgkin's lymphoma
Reid index (increased) Chronic bronchitis
Reinke crystals Leydig cell tumor
Renal cell carcinoma + cavernous
hemangioma + adenomas
Von Hippel-Lindau disease
Renal epithelial casts in urine Acute toxic/viral nephrosisRhomboid crystals, positively
birefringent
Pseudogout
Rib notching Coarctation of aorta
Roth spots in retina Endocarditis
Roleaux formation Multiple myeloma
Russell bodies Multiple myeloma
S3 Left-to-right shunt (VSD, PDA, ASD),
mitral regurg., LV failure (CHF)S4 Aortic stenosis, hypertrophic subaortic
stenosisSchwartzman reaction N. Meningitidis
Schiller-duval bodies Yolk sac tumor
Senile plaques Alzheimer's diseaseSignet ring cells Gastric carcinoma
Simian crease Down's syndrome
Skip lesions Crohn's
Slapped cheeks Erythema infectiosum (fifth disease)
Smith antigen SLESmudge cell Cll
Soap bubble on x-ray Giant cell tumor of boneSpike & dome on em of kidney tissue Membranous glomerulonephritis
Spitz nevus Benign juvenile melanoma
Splinter hemorrhages in fingernails Endocarditis
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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 of kidney
tissue
Poststreptococcal glomerulonephritis
Suboccipital lymphadenopathy Rubella
Sulfur granules Actinomyces israelii
Swollen gums, bruising, poor woundhealing, anemia
Scurvy (ascorbic acid, vitamin Cdeficiency) - 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-ablhybrid)
t(14:18) Follicular lymphomas (bcl-2 activation)Tabes dorsalis Tertiary symphilis
Tendon xanthomas (classically achilles) Familial hypercholesterolemiaThumb sign on lateral x-ray Epiglotitis (Haemophilus influenzae)
Thyroidization of kidney Chronic bacterial pyelonephritis
Tophi Gout
"Tram-track" appearance on lm Membranoproliferative glomerulonephritis
Trousseau's sign Visceral cancer, pancreatic
adenocarcinoma (migratorythrombophlebitis), hypocalcemia (carpal
spasm)Virchow's node Left supraclavicular node enlargement
from metastatic carcinoma of the stomach
Virchow's node Pulmonary embolism (triad = blood stasis,
endothelial damage, hypercoagulation)
Von recklinghausen's disease Neurofibromatosis with caf-au-lait spots
Von recklinghausen's disease of bone Osteitis fibrosa cystica ("brown tumor")
Wallenberg's syndrome PICA thrombosisWaterhouse-friderichsen syndrome Adrenal hemorrhage associated with
meningococcemiaWaxy casts Chronic end-stage renal disease
Wbc casts in urine Acute pyelonephritis
Wbcs in urine Acute cystitisWermer's syndrome MEN type I
Whipple's disease Malabsorption syndrome caused by
Tropheryma whippelii
Wilson's disease Hepatolenticular degeneration
"Wire loop" appearance on lm > Lupus nephropathy"Worst headache of my life" Berry aneurysm - associated with adult
polycystic kidney diseaseXanthochromia (csf) Subarachnoid hemorrhage
Xerostomia + arthritis +
keratoconjunctivitis Sicca
Sjogren's syndrome
Zenker's diverticulum > Upper GI diverticulum
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Zollinger-ellison syndrome Gastrin-secreting tumor associated with
ulcers
Deletion on chromosome 13 Retinoblastoma
Thrombocytopenia & eczema &
recurrent infex
Wiskott-Aldrich syndrome
Tree-bark calcification of aorta Syphilitic aortitis (3')Psammoma bodies 1- papillary carcinoma of thyroid or ovary
2- meningioma
3- malignant mesothelioma5-hydroxyindoleacetic acid increase Carcinoid syndrome
Bronze diabetes Hemochromatosis
Benzene Aplastic anemia
Dry tap Myelofibrosis
Cut potato lymph nodes Non-Hodgkins lymphoma
Most common cause of death in cystic
fibrosis
Pseudomonas infex
Klinefelter's karyo- & phenotype XXY, male eunuch
Ca-125 elevated Ovarian cancer+S100 antigen, -mucin Vulvar malignant melanoma
Pancoast tumor Apical lung tumor compressing cervicalsympathetic plexus, causing Horner's
syndrome
Hfe gene defect, chromosome 6 Hereditary hemochromatosis
Deficient activity of NADPH oxidase Chronic granulomatous disease of
childhood
Hla-dr5 & hla-b5 Hashimoto thyroiditis5p Cri du chat
Anti-scl-70 SclerodermaAnti-ss-b Sjogren's
Anti-nrnp Mixed connective tissue disease
Elevated alpha-fetoprotein Hepatocellular carcinoma
Loss of GTPase Ras mutation
T(14;18) Follicular lymphoma (bcl-2)
T(15;17 Acute promyleocytic leukemia
N-myc amplification NeuroblastomaFamilial p-53 mutation Li fraumeni syndrome
Ret mutation MEN IIaAflatoxin b1 causes Hepatocellular carcinoma
B-napthylamine causes Bladder cancer
Mc cause of viral pharyngitis AdenovirusDown's syndrome heart disease Cushion defects
Turner's syndrome heart disease Coarcted aorta
Order of mi enzymes Ck-mb & trop-i
AST
ldhSydenham chorea Rheumatic fever
Death from acute respiratory failure MyocarditisCyanosis in congenital heart disease Right to left shunt
Abnormal schilling test Pernicious anemia
Increased a2 hemoglobin B thalassemia minor
Low serum Fe with low TIBC Anemia of chronic diseasePizz allele Homozygous defect in a1-antitrypsin
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secretion, predisposing to panacinar
emphysema
Lemon-yellow skin Pernicious anemia
Absence of serum haptoglobins Hemolytic anemia
Increased hemoglobin f B thalassemia majorPositive ham test Paroxysmal nocturnal hemoglobinuria
Schistocytes TTP
Spherocytes w/ negative coomb's test Hereditary spherocytosisSpherocytes w/ positive coomb's test Waha
Postive t.r.a.p. Test Hairy cell leukemia
Erythrocytosis w/ low erythropoeitin Polycytemia vera
Tear-drop erythrocytes Chronic idiopathic myelofibrosis
T(11;14) Mantle cell lymphoma
Anergy to skin test ag Sarcoidosis
Q fever Rickettsial pneumonia from unpasteurizedmilk
Low glucuronyl transferase Crigler-Najar, Gilbert syndromes
(liver enzyme conjugating billirubin)
Anti-smooth muscle ab Autoimmune hepatitisFatty food intolerance Cholelithiasis
Saber shin Skeletal syphillis
Spindle-shaped cells w/ herringbone
pattern
Fibrosarcoma
T(11;22)(q24;12) translocation Ewing sarcoma
(malignant round cell tumor of bone)Spike & dome Membranous glomerulonephritis (a
nephrotic synd)Smoky brown urine Nephritis syndrome
Bun:creatinine > 15 Prerenal azotemia
Precocious male puberty Leydig cell tumor
Precocious female puberty Granulosa cell tumor
Mc urinary tract tumor Transitional cell
Increased total psa, decreased % free
psa
Prostatic carcinoma
Increased total psa, no change in % free
psa
Bph
Complete hydatidiform mole karyotype 46XX, but all paternalHla-dr3 & hla-b8 Increased risk of Grave's disease
Plummer disease Grave's, without the exophthalmos
Increased pth, hypercalcemia Parathyroid adenomaIncreased pth, hypocalcemia Renal disease
Short 4th or 5th metacarpals &
metatarsals
Pseudohypoparathyroidism (AR)
Buffalo hump Hypercortisolism (Cushing's)
21-hydroxylase deficiency Virilism w/ salt loss and hypotension11-hydroxylase deficiency Virilism w/ salt retention and HTN
"Target" lesion Erythema multiformeAccanthosis nigricans Visceral malignancy
Small blue cell bone tumor Ewing sarcoma
Blue sclera Osteogenesis imperfecta
Mc site of cerebrovascularthrombosis/embolism
Middle cerebral a.
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Maternal folic acid deficiency Fetal neural tube defects
Mc cause of intracerebral hemorrhage Htn
Mc site of intracerebral hemorrhage Basal ggl & thalamus
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