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. Addison’s disease: 1° adrenocortical deficiency
3. Albright’s syndrome: Polyostotic fibrous dysplasia,
precocious puberty, café-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 Recklinghausen’s disease)
26. “Chocolate cysts”: Endometriosis (frequently involves
both ovaries)
4. Albuminocytologic dissociation: Guillain-Barré (↑
protein in CSF with only modest ↑ in cell count)
5. Alport’s 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. Anti–basement membrane antibodies: Goodpasture’s
syndrome
9. Anti–epithelial cell antibodies: Pemphigus vulgaris
27. “Fat, female, forty, and fertile”: Acute cholecystitis
28. “Hair-on-end” appearance on x-ray: β-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 [α1-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: Marfan’s syndrome
17. Argyll Robertson pupil: Neurosyphilis
18. Arnold-Chiari malformation: Cerebellar tonsillar
herniation
19. Aschoff bodies: Rheumatic fever
20. Atrophy of the mammillary bodies: Wernicke’s
encephalopathy
36. “Worst headache of my life”: Berry
aneurysm—associated with adult polycystic kidney
disease
37. Babinski’s sign: UMN lesion
38. Baker’s cyst in popliteal fossa: Rheumatoid arthritis
39. Bartter’s syndrome: Hyperreninemia
40. Basophilic stippling of RBCs: Lead poisoning
21. Auer rods: Acute myelogenous leukemia (especially the
promyelocytic type)
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41. Becker’s muscular dystrophy: Defective dystrophin; less
severe than Duchenne’s
42. Bell’s palsy: LMN CN VII palsy
43. Bence Jones proteins: Multiple myeloma (kappa or
lambda Ig light chains in urine), Waldenström’s
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. Bouchard’s nodes: Osteoarthritis (PIP swelling 2° to
osteophytes)
52. Boutonnière deformity: Rheumatoid arthritis
53. Branching rods in oral infection: Actinomyces israelii
54. Brushfield’s spots: Down syndrome
55. Bruton’s disease: X-linked agammaglobulinemia
56. Budd-Chiari syndrome: Posthepatic venous thrombosis
57. Buerger’s disease: Small/medium-artery vasculitis
58. Burkitt’s lymphoma: 8:14 translocation; associated with
EBV
59. Burton’s lines: Lead poisoning
60. C-ANCA, P-ANCA: Wegener’s granulomatosis,
polyarteritis nodosa
61. Café-au-lait spots on skin: Neurofibromatosis
62. Caisson disease: Gas emboli
63. Calf pseudohypertrophy: Duchenne’s 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. Charcot’s triad: Multiple sclerosis (nystagmus, intention
tremor, scanning speech), cholangitis (jaundice, RUQ
pain, fever)
72. Chédiak-Higashi disease: Phagocyte deficiency
73. Cheyne-Stokes respirations: Central apnea in CHF and ↑
intracranial pressure
74. Chronic atrophic gastritis: Predisposition to gastric
carcinoma
75. Chvostek’s sign: Hypocalcemia (facial muscle spasm upon
tapping)
76. Clear cell adenocarcinoma of: DES exposure in utero
77. Clue cells: Gardnerella vaginitis
78. Codman’s 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. Cori’s 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 Bowman’s capsule: Rapidly progressive
crescentic glomerulonephritis
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89. Crigler-Najjar syndrome: Congenital unconjugated
hyperbilirubinemia
112. Gaucher’s disease: Glucocerebrosidase deficiency
113. Ghon focus: 1° TB
90. Curling’s ulcer: Acute gastric ulcer associated with severe 114. Gilbert’s syndrome: Benign congenital unconjugated
burns
hyperbilirubinemia
91. Currant-jelly sputum: Klebsiella
115. Glanzmann’s thrombasthenia: Defect in platelet
aggregation
92. Curschmann’s spirals: Bronchial asthma (whorled
mucous plugs)
116. Goodpasture’s syndrome: Autoantibodies against
alveolar and glomerular basement membrane proteins
93. Cushing’s ulcer: Acute gastric ulcer associated with CNS
injury
117. Gowers’ maneuver: Duchenne’s (use of patient’s arms to
help legs pick self off the floor)
94. D-dimers: DIC
95. Depigmentation of neurons in: Parkinson’s disease (basal 118. Guillain-Barré syndrome: Idiopathic polyneuritis
ganglia disorder––rigidity, resting tremor,
119. Hand-Schüller-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-Schüller-Christian disease
(occurs with and without embryo)
98. Dog or cat bite: Pasteurella multocida
123. Heberden’s nodes: Osteoarthritis (DIP swelling 2° to
99. Donovan bodies: Granuloma inguinale
osteophytes)
100. Dressler’s syndrome: Post-MI fibrinous pericarditis
124. Heinz bodies: G6PD deficiency
101. Duchenne’s 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-Schönlein 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. Eisenmenger’s 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 (“waiter’s tip”)
132.
107. Erythema chronicum migrans: Lyme disease
108. Fanconi’s syndrome: Proximal tubular reabsorption
defect
109. Fatty liver: Alcoholism
HLA-B27: Reiter’s syndrome, ankylosing spondylitis
HLA-DR3 or -DR4: Diabetes mellitus type 1 (caused by
autoimmune destruction of β cells)
Homer Wright rosettes: Neuroblastoma
Honeycomb lung on x-ray: Interstitial fibrosis
Howell-Jolly bodies: Splenectomy (or nonfunctional
spleen)
110. Ferruginous bodies: Asbestosis
111. Gardner’s syndrome: Colon polyps with osteomas and
soft tissue tumors
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133. Huntington’s disease: Caudate degeneration (autosomal
dominant)
134. Hyperphagia + hypersexuality + hyperorality +
hyperdocility: Klüver-Bucy syndrome (amygdala)
135. Hyperpigmentation of skin: 1° adrenal insufficiency
(Addison’s disease)
136. Hypersegmented neutrophils: Macrocytic anemia
137. Hypertension + hypokalemia: Conn’s syndrome
138. Hypochromic microcytosis: Iron deficiency anemia, lead
poisoning
139. Increased α-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
Peyer’s patches)
142. Berger’s 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. Horner’s syndrome: Ptosis, miosis, and anhidrosis
146. Low serum ceruloplasmin: Wilson’s disease
147. Philadelphia chromosome (bcr-abl ): CML (may
sometimes be associated with AML)
148. Rib notching: Coarctation of aorta
149. t(8;14): Burkitt’s lymphoma (c-myc activation)
150. Janeway lesions: Endocarditis
151. Jarisch-Herxheimer reaction: Syphilis—overaggressive
treatment of an asymptomatic patient that causes
symptoms due to rapid lysis
152. Job’s syndrome: Neutrophil chemotaxis abnormality
153. Kaposi’s sarcoma: AIDS in MSM (men who have sex with
men)
154. Kartagener’s syndrome: Dynein defect
155. Kayser-Fleischer rings: Wilson’s disease
156. Keratin pearls: Squamous cell carcinoma
157. Kimmelstiel-Wilson nodules: Diabetic nephropathy
158. Klüver-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: Marfan’s syndrome (fibrillin deficit)
164. Lesch-Nyhan syndrome: HGPRT deficiency
165. Lewy bodies: Parkinson’s disease
166. Libman-Sacks disease: Endocarditis associated with SLE
167. Lines of Zahn: Arterial thrombus
168. Lisch nodules: Neurofibromatosis (von Recklinghausen’s
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. McArdle’s disease: Muscle phosphorylase deficiency
174. McBurney’s 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),
Waldenström’s (M protein = IgM) macroglobulinemia
177. Myxedema: Hypothyroidism
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178. Necrotizing vasculitis (lungs) and necrotizing
glomerulonephritis: Wegener’s and Goodpasture’s
(hemoptysis and glomerular disease)
179. Needle-shaped, negatively birefringent crystals: Gout
203. Polyneuropathy, cardiac pathology, and edema: Dry
beriberi (thiamine, vitamin B1 deficiency)
204. Pompe’s disease: Lysosomal glucosidase deficiency
associated with cardiomegaly
180. Negri bodies: Rabies
181. Nephritis + cataracts + hearing loss: Alport’s syndrome
205. Port-wine stain: Hemangioma
206. Positive anterior “drawer sign”: Anterior cruciate
ligament injury
182. Neurofibrillary tangles: Alzheimer’s disease
183. Niemann-Pick disease: Sphingomyelinase deficiency
184. No lactation postpartum: Sheehan’s syndrome (pituitary
infarction)
185. Nutmeg liver: CHF
186. Occupational exposure to asbestos: Malignant
mesothelioma
187. Osler’s nodes: Endocarditis
188. Owl’s eye: CMV
189. Painless jaundice: Pancreatic cancer (head)
190. Palpable purpura on legs and buttocks:
Henoch-Schönlein purpura
191. Pancoast’s tumor: Bronchogenic apical tumor associated
with Horner’s syndrome
192. Pannus: Rheumatoid arthritis
193. Parkinson’s disease: Nigrostriatal dopamine depletion
194. Periosteal elevation on x-ray: Pyogenic osteomyelitis
195. Peutz-Jeghers syndrome: Benign polyposis
196. Peyronie’s disease: Penile fibrosis
197. Pick bodies: Pick’s disease
198. Pick’s disease: Progressive dementia, similar to
Alzheimer’s
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-Barré syndrome
207. Pott’s disease: Vertebral tuberculosis
208. Pseudopalisade tumor cell arrangement: Glioblastoma
multiforme
209. Pseudorosettes: Ewing’s sarcoma
210. Ptosis, miosis, anhidrosis: Horner’s syndrome (Pancoast’s
tumor)
211. Rash on palms and soles: 2° syphilis, Rocky Mountain
spotted fever
212. Raynaud’s 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: Hodgkin’s lymphoma
217. Reid index (increased): Chronic bronchitis
218. Reinke crystals: Leydig cell tumor
219. Reiter’s syndrome: Urethritis, conjunctivitis, arthritis
220. Renal cell carcinoma + cavernous hemangiomas +
adenomas: von Hippel–Lindau disease
221. Renal epithelial casts in urine: Acute toxic/viral nephrosis
222. Rhomboid crystals, positively birefringent: Pseudogout
223. Roth’s spots in retina: Endocarditis
224. Rotor’s syndrome: Congenital conjugated
hyperbilirubinemia
225. Rouleaux formation (RBCs): Multiple myeloma
226. Russell bodies: Multiple myeloma
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227. S3: Left-to-right shunt (VSD, PDA, ASD), mitral
regurgitation, LV failure (CHF)
228. S4: Aortic stenosis, hypertrophic subaortic stenosis
229. Sézary syndrome: Cutaneous T-cell lymphoma
230. Schiller-Duval bodies: Yolk sac tumor
231. Senile plaques: Alzheimer’s disease
232. Sheehan’s syndrome: Postpartum pituitary necrosis
233. Shwartzman reaction: Neisseria meningitidis
234. Signet-ring cells: Gastric carcinoma
235. Simian crease: Down syndrome
236. Sipple’s syndrome: MEN type IIa
237. Sjögren’s syndrome: Dry eyes, dry mouth, arthritis
238. Skip lesions: Crohn’s
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: Burkitt’s lymphoma
246. Streaky ovaries: Turner’s syndrome
247. String sign on x-ray: Crohn’s 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. Trousseau’s sign: Visceral cancer, pancreatic
adenocarcinoma (migratory thrombophlebitis),
hypocalcemia (carpal spasm)
261. Virchow’s node: Left supraclavicular node enlargement
from metastatic carcinoma of the stomach
262. Virchow’s triad: Pulmonary embolism (triad = blood
stasis, endothelial damage, hypercoagulation)
263. von Recklinghausen’s disease: Neurofibromatosis with
café-au-lait spots
264. von Recklinghausen’s disease of bone: Osteitis fibrosa
cystica (“brown tumor”)
265. Wallenberg’s 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. Wermer’s syndrome: MEN type I
251. Swollen gums, bruising, poor wound healing, anemia:
271. Whipple’s 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.
Wilson’s
disease: Hepatolenticular degeneration
collagen synthesis
273.
Xanthochromia
(CSF): Subarachnoid hemorrhage
252. Systolic ejection murmur (crescendo-decrescendo):
274. Xerostomia + arthritis + keratoconjunctivitis sicca:
Aortic valve stenosis
Sjögren’s syndrome
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275. Zenker’s diverticulum: Upper GI diverticulum
276. Zollinger-Ellison syndrome: Gastrin-secreting tumor
associated with ulcers
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