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 rbcs Bence-jones proteins Bilateral hilar adenopathy, uveitis Birbeck granules on em Bloody tap on lp Blue bloater Blue-domed cysts Blue sclera Boot-shaped heart on x-ray Bouchard's nodes Boutonniere deformity Branching rods in oral infection Brown tumor of bone Brushfield spots Bruton's lines c-ANCA p-ANCA Café-au-lait spots Preceeds squamous cell carcinoma Guillan-Barre (incr. Protein in CSF w/ modest incr. 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 <escaped synovial fluid> Ankylosing spondylitis Lead poisoning Multiple myeloma (kappa or lambda Ig light chains in urine), Waldenstroem's macroglobulinemia (IgM) Sarcoidosis Histiocytosis X (eosinophilic granuloma) <tennis rackets> Subarachnoid hemorrhage Chronic bronchitis Fibrocystic change of the breast Osteogenesis imperfecta Tetralogy of Fallot; RV hypertrophy Osteoarthritis <PIP swelling secondary to osteophytes> 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 Calf 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 cysts 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 bowman'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<extracellular multilaminated bodies among granulosa cells> 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 <Apnea, followed by gradually increasing hyperpnea> Endometriosis (freq. Involve both ovaries) Predisposition to gastric carcinoma Hypocalcemia <facial mm spasm on tapping> Gardnerella vaginitis Osteosarcoma Mycoplasma pneumoniae; infectious mononucleosis Myxedema 2' syphilis Patent ductus arteriosus Chronic hypertension <coagulated exudates fr. Retinal capillaries, white & fluffy> Measles Toxic or viral hepatitis <dead, shrunken hepatocytes> Herpesvirus Rapidly progressive crescentic glomerulonephritis Klebsiella Bronchial asthma (whorled mucous plugs) DIC Parkinson's disease (basal ggl. Disorder-rigidity, resting tremor, bradykinesia Pellagra (niacin--vit B3 deficiency) Hand-Schueller-Christian disease < a form of histiocytosis > Pasteurella multocida Granuloma inguinale <large mononuclear cells containing Donovania granulomatis. Stain blue w/ pink capsules> Ehlers-Danlos syndrome Erythema chronicum migrans Fat+female+fertile+forty Fatty liver Ferruginous bodies Ghon focus Gower's maneuver Hair-on-end appearance on x-ray Hampton's hump on x-ray Hbs Hcg elevated Heberden's nodes Heinz bodies Heterophil antibodies Hgb f High-output cardiac failure (dilated cardiomyopathy) Hla-b27 [2] Hla-dr3 or -dr4 Homer wright rosettes Honeycomb lung on x-ray Howell-jolly bodies Hyperphagia + hypersexuality + hyperorality + hyperdocility 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 Kimmelstiel-wilson nodules Lyme disease Acute cholecystitis Alcoholism Asbestosis Primary tuberculosis Duchenne's MD Beta thalassemia Pulmonary embolism<convex opacity next to chest wall or diaphragm> Sickle cell anemia Choriocarcinoma (testicular cancer), multiple pregnancy, hyatidiform mole Osteoarthritis < DIP swelling secondary to osteophytes> G6PD deficiency < refractile granules in rbcs> Infectious mononucleosis (EBV) Thalassemia major Wet beri-beri (thiamine--vit B1 deficiency) Reiter's syndrome, ankylosing spondylitis T1dm Neuroblastoma Interstitial fibrosis Splenectomy or nonfunctional spleen <small round nuclear remnants in rbcs> Kluever-Bucy syndrome (amygdala) Primary adrenal insufficiency (Addison's disease Macrocytic anemia Cushing's & Conn'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 <small hemorrhagic lesions in palms or soles> 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 glomeruli on if Lytic bone lesions on x-ray Mallory bodies Mcburney's sign Mlf 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 (bcr:abl) Human papilloma virus Measles<minute blueish-white lesions surrounded by a bright ring on mucous membrane of cheeks> Diabetic ketoacidosis Marfan's syndrome (fibrillin deficit) Parkinson's disease (basal ggl. Disorder-rigidity, resting tremor, bradykinesia Arterial thrombus <striations on surface of blood clot, due to layers of platelets> Neurofibromatosis (von Recklinhausen's) <minute pigmented mass in the iris> Wilson's disease Epidural hematoma Poststreptococcal glomerulonephritis Multiple myeloma Alcoholic liver disease <large accum. Of eosinophilic material in damaged liver cells> 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 <abnormal bodies w/in nerve cells> Alport's syndrome Alzheimer's disease Sheehan's syndrome CHF Malignant mesothelioma Papillary carcinoma of the thyroid Subacute endocarditis <small, tender, discolored node on pads of fingers & toes> Cytomegalo virus Pancreatic cancer (head) Henoch-Schoenlein purpura <purpura: spont. Bleeding in subcut. Tissues> 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 Rbc casts in urine Recurrent pulmonary pseudomonas & s. Aureus infex Red urine in morning Reed-Sternberg cells Reid index (increased) Reinke crystals Renal cell carcinoma + cavernous hemangioma + adenomas Renal epithelial casts in urine Rhomboid crystals, positively birefringent Rib notching Roth spots in retina Roleaux formation Russell bodies S3 S4 Schwartzman reaction Schiller-duval bodies Senile plaques Signet ring cells Simian crease Skip lesions Slapped cheeks Smith antigen Smudge cell Soap bubble on x-ray Spike & dome on em of kidney tissue Spitz nevus Splinter hemorrhages in fingernails 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, B1 def.) Hemangioma ACL injury Glioblastoma multiforme Ewing's sarcoma Horner's syndrome (Pancoast's tumor) Secondary syphillis, Rocky Mountain spotted fever Acute glomerulonephritis Cystic fibrosis Paroxysmal nocturnal hemoglobinuria Hodgkin's lymphoma Chronic bronchitis Leydig cell tumor Von Hippel-Lindau disease Acute toxic/viral nephrosis Pseudogout Coarctation of aorta Endocarditis Multiple myeloma Multiple myeloma <globular intracytoplasmic deposits of acidophilic material w/in plasma cells> Left-to-right shunt (VSD, PDA, ASD), mitral regurg., LV failure (CHF) Aortic stenosis, hypertrophic subaortic stenosis N. Meningitidis Yolk sac tumor Alzheimer's disease Gastric carcinoma Down's syndrome Crohn's Erythema infectiosum (fifth disease) SLE Cll Giant cell tumor of bone Membranous glomerulonephritis Benign juvenile melanoma <cutaneous malformation w/ large epithelial-like cells> 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 (crescendodecrescendo) t(8:14) t(9:22) t(14:18) Tabes dorsalis Tendon xanthomas (classically achilles) Thumb sign on lateral x-ray Thyroidization of kidney Tophi "Tram-track" appearance on lm 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 Waxy casts Wbc casts in urine Wbcs in urine Wermer's syndrome Whipple's disease Wilson's disease "Wire loop" appearance on lm "Worst headache of my life" Xanthochromia (csf) Xerostomia + arthritis + keratoconjunctivitis Sicca Zenker's diverticulum Burkitt's lymphoma Scarlet fever Turner's syndrome Crohn's disease Poststreptococcal 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 (bcr-abl hybrid) Follicular lymphomas (bcl-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 GI diverticulum Zollinger-ellison syndrome Deletion on chromosome 13 Thrombocytopenia & eczema & recurrent infex Tree-bark calcification of aorta Psammoma bodies 5-hydroxyindoleacetic acid increase Bronze diabetes Benzene Dry tap Cut potato lymph nodes Most common cause of death in cystic fibrosis Klinefelter's karyo- & phenotype Ca-125 elevated +S100 antigen, -mucin Pancoast tumor Hfe gene defect, chromosome 6 Deficient activity of NADPH oxidase Hla-dr5 & hla-b5 5p Anti-scl-70 Anti-ss-b Anti-nrnp Elevated alpha-fetoprotein Loss of GTPase T(14;18) T(15;17 N-myc 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 Carcinoid 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 (bcl-2) Acute promyleocytic leukemia Neuroblastoma Li fraumeni syndrome MEN IIa Hepatocellular carcinoma Bladder cancer Adenovirus Cushion defects Coarcted aorta Ck-mb & trop-i AST ldh Rheumatic fever Myocarditis Right to left shunt Pernicious anemia B thalassemia minor Anemia of chronic disease Homozygous defect in a1-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 erythropoeitin 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 Hla-dr3 & hla-b8 Plummer disease Increased pth, hypercalcemia Increased pth, hypocalcemia Short 4th or 5th metacarpals & metatarsals Buffalo hump 21-hydroxylase deficiency 11-hydroxylase deficiency "Target" lesion Accanthosis nigricans Small blue cell bone tumor Blue sclera Mc site of cerebrovascular thrombosis/embolism secretion, predisposing to panacinar emphysema Pernicious anemia Hemolytic anemia B thalassemia major Paroxysmal nocturnal hemoglobinuria TTP Hereditary spherocytosis Waha Hairy cell leukemia Polycytemia 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 Mc cause of intracerebral hemorrhage Mc site of intracerebral hemorrhage Fetal neural tube defects Htn Basal ggl & thalamus