USMLE Gold Pearls

  1. Albumino-Cytologic Dissociation
    Guillain-Barre (markedly increased protein in CSF w/ only modest increase in cell count)
  2. Antiplatelet Antibodies
    Idiopathic thrombocytopenic purpura
  3. Arachnodactyly
  4. Aschoff Bodies
    Rheumatic fever
  5. Auer Rods
    Acute promyelocytic leukemia (AML type M3)
  6. Autosplenectomy
    • Sickle cell anemia: switch a glu --> val in beta chain
    • Low O2 increased sickling
    • Aplastic crisis w/ B19 (Parvovirus ssDNA) infection
    • Salmonella osteomyelitis
    • Vaso-occlusive painful crises
    • Hydroxyurea as Txt (increased HbF) and bone marrow transplant
  7. Babinski
    UMN lesion
  8. Basophilic Stippling of RBCs
    Lead poisoning
  9. Bence Jones Protein
    • Multiple myeloma - free light chains (either kappa or lambda)
    • Waldenstrom's macroglobinemia
  10. Birbeck Granules
    Histiocytosis X (eosinophilic granuloma)
  11. Blue Bloater
    Chronic Bronchitis (at least 3 months for at least 2 years of excessive mucus secretion & chronic recurrent productive cough)
  12. Boot-Shaped Heart
    Tetralogy of Fallot
  13. Bouchard's Nodule
    Osteoarthritis (proximal IP joint of fingers)
  14. Boutonniere's Deformity
    RA Flexed proximal and extended distal IP joint
  15. Brown Tumor
  16. Brushfield Spots
  17. Call-Exner Bodies
    • Granulosa cell tumor: associated w/ endometrial hyperplasia & carcinoma
    • Granuloma - Theca cell tumor
  18. Cardiomegaly with Apical Atrophy
    Chagas' Disease
  19. Chancre
    Primary Syphilis
  20. Chancroid
    Haemophilus ducreyi
  21. Charcot Triad
    MS - nystagmus, intention tremor, scanning speech
  22. Charcot-Leyden Crystals
    Bronchial asthma
  23. Cheyne-Stokes breathing
    Cerebral lesion
  24. Chocolate Cysts
  25. Chvostek's Sign
    Hypocalcemia - facial spasm in tetany
  26. Clue Cells
    Gardnerella vaginitis
  27. Codman's Triangle
  28. Cold Agglutinins
    • Mycoplasma pneumoniae
    • Infectious mononucleosis
  29. Condyloma Lata
    Secondary Syphilis
  30. Cotton Wool Spots
    • HTN
    • aka - cytoid bodies seen w/ SLE (yellowish cotton wool fundal lesions)
  31. Councilman Bodies
    Dying hepatocytes - Hep B
  32. Crescents in Bowman's Capsule
    Rapidly progressive (crescentic) glomerulonephritis
  33. Currant-Jelly Sputum
  34. Curschmann's Spirals
    Bronchial asthma
  35. Depigmentation of Substantia Nigra
  36. Donovan Bodies
    Granuloma inguinale (STD)
  37. Eburnation
    Osteoarthritis (polished, ivory-like appearance of bone)
  38. Ectopia Lentis
  39. Erythema Chronicum Migrans
    Lyme Disease
  40. Fatty liver
  41. Ferruginous Bodies
    Asbestosis - and iron laden
  42. Ghon Focus / Complex
    Tuberculosis (primary and secondary respectively)
  43. Glitter Cells
    Acute Pyelonephritis
  44. Gower's Maneuver
    Duchenne's MD - use of arms to stand
  45. Heberden's Nodes
    Osteoarthritis - distal IP joint of finger
  46. Heinz Bodies
    G6PDH deficiency
  47. Heterophil Antibodies
    Infectious mononucleosis (EBV)
  48. Hirano Bodies
  49. Hypersegmented PMNs
    Megaloblastic anemia
  50. Hypochromic Microcytic RBCs
    Iron deficiency anemia or beta-Thalassemia
  51. Jarisch-Herxheimer Reaction
    Syphilis - over aggressive tx of an asymptomatic pt that causes symptoms secondary to rapid lysis
  52. Joint Mice
    Osteoarthritis (fractured osteophytes)
  53. Kaussmaul Breathing
    Acidosis / Diabetic Ketoacidosis
  54. Keratin Pearls
    Squamous Cell CA of Skin - actinic keratosis is a precursor
  55. Keyser-Fleisher Ring
  56. Kimmelstiel-Wilson Nodules
    Diabetic nephropathy - Nodular Glomerulosclerosis nodules of mesangial matrix
  57. Koilocytes
    HPV 6 & 11 (condyloma acuminatum - benign) and HPV 16 &18 (malignant association)
  58. Koplik Spots
  59. Lewy Bodies
    Parkinson's (eosinophilic inclusions in damaged substantia nigra cells)
  60. Lines of Zahn
    Arterial thrombosis
  61. Lisch Nodules
    Neurofibromatosis (von Recklinhausen's disease) = pigmented iris hamartomas
  62. Lumpy-Bumpy IF Glomeruli
    Poststreptococcal glomerulonephritis = prototype of nephritic syndrome
  63. Mallory Bodies
    Alcoholic hepatitis
  64. McBurney's Sign
    Appendicitis (McBurney's Point is 2/3 of the way from the umbilicus to ASIS)
  65. Michealis-Gutmann Bodies
    Malakoplakia - lesion on bladder due to macros & calcospherites (M-G Bodies): usually due to E. coli
  66. Monoclonal Antibody Spike
    • Multiple myeloma - this is called the M protein (usually IgG or IgA)
    • MUGS
  67. Myxedema
  68. Negri Bodies
  69. Neuritic Plaques
  70. Neurofibrillary Tangles
  71. Non-pitting Edema
    • Myxedema
    • Anthrax toxin
  72. Notching or the Ribs
    Coarctation of Aorta
  73. Nutmeg Liver
    CHF - causing congested liver
  74. Owls Eye Cells
    • CMV
    • Reed Sternburg Cells (Hodgkin Lymphoma)
    • Aschoff cells seek w/ Rheumatic Fever
  75. Painless Jaundice
    Pancreatic CA (head)
  76. Pannus
    • RA, also see morning stiffness that decreases w/ joint use
    • HLA-DR4
  77. Pautrier's Microabscesses
    Mycosis fungoides (cutaneous T-cell lymphoma), Sezary
  78. Philadelphia Chromosome
  79. Pick Bodies
    Pick's Disease
  80. 2 types of COPD
    • Pink Puffer - Type A: Emphysema (Centroacinar - smoking, Panacinar - alpha 1 antitrypsin deficiency)
    • Blue Bloater - Type B: Bronchitis
  81. Podagra
    Gout (MP joint of hallux)
  82. Port-Wine Stain
  83. Posterior Anterior Drawer Sign
    Tearing of ACL
  84. Psammoma Bodies
    • Papillary adenocarcinoma of the thyroid
    • Serous papillary cyst adenocarcinoma of the ovary
    • Meningioma
    • Mesothelioma
  85. Pseudohypertrophy
    Seen w/ Duchenne MD at the calf muscle due to increased fat
  86. Punched-Out Bone Lesions
    Multiple myeloma
  87. Rash on Palms and Soles
    • Secondary Syphilis
    • RMSF
    • Coxsackie virus infection: Hand-Foot-Mouth Disease
  88. Red Morning Urine
    Paroxysmal nocturnal hemoglobinuria. You will use Ham's Test to confirm
  89. Reed-Sternberg Cells
    Hodgkin's Disease
  90. Reid Index Increased
    Chronic bronchitis = increased ratio of bronchial gland to bronchial wall thickness
  91. Reinke Crystals
    Leydig cell tumor
  92. Rouleaux Formation
    Multiple myeloma - RBCs stacked as poker chips
  93. S3 Heart Sound
    • L--> R Shunt (VSD, PDA, ASD)
    • Mitral Regurg
    • LV Failure
  94. S4 Heart Sound
    • Pulmonary Stenosis
    • Pulmonary HTN
  95. Schwartzman Reaction
    Neisseria menigitidis - impressive rash with bugs
  96. Smith Antigen
    • SLE (also anti-dsDNA)
    • Malor Rash, Wire look kidney lesions, Joint pain, False (+) syphilis test (VDRL)
    • 90% 14-45 yo females
    • Also seen w/ use of INH; Procainamide, Hydralazine = SLE-like syndrome
  97. Soap Bubble on X-ray
    Giant cell tumor of bone
  98. Spike & Dome Glomeruli
    • Membranous glomerulonephritis = Nephrotic syndrome
    • Spike = BM material
    • Dome = immune complex deposits (IgG or C3)
  99. Sting Sign on X-ray
    Crohn's - bowel wall thickening
  100. Target Cells
    Thalassemia - in alpha-Thalassemia w/ no alpha gene: Hydrops Fetalis & Intrauterine death associations = HbBarts
  101. Tendinous Xanthomas
    Familial Hypercholesterolemia
  102. Thyroidization of Kidney
    Chronic pyelonephritis
  103. Tophi
  104. Tram-Track Glomeruli
    Membranoproliferative GN: Nephritic Syndrome - BM is duplicated into 2 layers
  105. Trousseau's Sign
    • Visceral CA, classically pancreatic (migratory thrombophlebitis)
    • Hypocalcemia (carpal spasm)
    • These are two entirely different disease processes and different signs w/ the same name
  106. Virchow's Node
    Supraclavicular node enlargement by metastatic carcinoma of the stomach
  107. Warthin-Finkeldey Giant Cells
  108. WBC Casts
  109. Whipple's Triad
    CNS disfunction - Hypoglycemic episodes - glu injections reverse CNS symptoms
  110. Wire Loop Glomeruli
    Lupus nephropathy, type IV (diffuse proliferative form)
  111. Increased AFP in amniotic fluid or mother's serum
    • Spina Bifida
    • Anencephaly
  112. Increased Uric Acid
    • Gout
    • Lesch Nyjan
    • Myeloproliferative Disorders
    • Diuretics (Loop and Thiazides)
  113. Decreased FEV1/FVC
  114. "Ground Glass" on chest X-ray (Hayaline)
    • Due to Pneumocystis carinii
    • Seen w/ Atelectasia
  115. Honeycombing of lung
    Seen w/ asbestosis (reactive lung disease)
  116. Crescents
    Goodpasture syndrome (pneumonia w/ hemoptysis & rapidly progressive glomerulonephritis)
  117. Linear Ig Deposits
    Goodpasture's Syndrome
  118. 45 degree branching points
  119. PAS (+) Dutcher Bodies
    Waldenstrom's Macroglobulinemia = increased IgM = Hyperviscosity
  120. "Ground Glass" in Abdomen (Hyaline)
    Seen in hepatocytes of healthy carriers of HBsAg in liver biopsies
  121. "Signet Ring" Cells
    Cells that replace the ovaries, due to Krukenberg's tumor that has metastasized from the stomach
  122. Ground Glass Appearance (Hyaline)
    • Seen w/ progressive multifocal leukoencephalopathy oligodendrocytes
    • Nuclei seen in Papillary CA of the thyroid (malignant)
  123. Congo Red
    Shows amyloid deposition in plaques and vascular wall
  124. Meningiomas and Progesterone
    Some meningiomas have progesterone receptors = rapid growth in pregnancy can occur
  125. Tuberous Sclerosis Triad
    • Seizures
    • Mental Retardation
    • Leukoderma (congenital facial white spots or macules): angiofibromas
  126. Cowdry A Inclusions
    Seen w/ herpes simples encephalitis - in oligodendroglia
  127. Devic's Syndrome
    • Neuromyelitis Optica
    • A variant of MS: rapid demyelination of the optic nerve & spinal cord w/ paraplegia
  128. c-erb B2
    Breast Cancer association
  129. Foster-Kennedy Syndrome
    A tumor causing blindness and loss of smell w/ papilloedema
  130. Hoffman's Sign
    Flicking of the middle finger's nail
  131. Red Nucleus Destruction
    Intention Tremors of arm
  132. Ventral Spinocerebellar tract
    Unconscious proprioception of lower extremities
  133. Dorsal Spinocerebellar tract
    Unconscious proprioception and fine motor movements
  134. Cuneocerebellar Tract
    Unconscious proprioception and fine motor movement of UE
  135. Dorsal Column
    Conscious proprioception of the body
  136. Lateral Spinothalamic Tract
    Pain and Temp sensation
  137. Ventral Spinothalamic Tract
    Light touch preception
  138. SVA
    Taste and Smell
  139. GSE
    Muscles of the eye and tongue
  140. SSA
    Vision; Hearing; Equilibrium
  141. GVA
    • Sensation of tongue; soft palate
    • Carotid Body and Sinus innervation
  142. GVE
    • Edinger Westphal = parasympathetic eye innervation
    • Gland innervation = secretion
    • Viscera
  143. GSA
    • Pain and temp of face
    • Sensation of external ear
  144. SVE
    Innervation of muscles of mastication, facial expressions, larynx and pharynx
  145. LMN Lesion
    • Werndig Hoffman (progressive infantile muscular atrophy)
    • Polimyelitis
  146. Sensory Pathway Lesion
    • Subacute Combined Degeneration = Friedrich's Ataxia = B12 deficiency
    • Tabes Dorsalis (Neurosyphilis)
  147. Both UMN and LMN Lesion
    ALS - Lou Gherig's Disease
  148. Both Sensory & Motor Lesion
    • Brown Sequard
    • Anterior Spinal artery Occlusion
  149. Suprachiasmatic Nucleus
    Controls circadian rhythm
  150. Ventromedial Nucleus
    Satiety center, Savage behavior and obesity with lesion
  151. Lateral Nucleus
    Induces eating, Starvation with lesion
  152. Arcuate Nucleus
    Release of PIF (dopa-ergic neurons)
  153. Mamillary Bodies
    Can have hemorrhage as seen in Wernicke's Encephalopathy
  154. Acanthocytes
    RBC's w/ spiny projections. Seen in Abetalopoproteinemia
Card Set
USMLE Gold Pearls
Hallmark Findings