Usmle - Classic Hallmarks

Front 1

Albumino-Cytologic Dissociation

Back 1

Guillain-Barre (markedly increased protein in CSF with only modest increase in cell count)

Front 2

Antiplatelet Antibodies

Back 2

Idiopathic thrombocytopenic purpura

Front 3

Arachnodactyly

Back 3

Marfan’s

Front 4

Aschoff Bodies

Back 4

Rheumatic fever

Front 5

Auer Rods

Back 5

Acute promyelocytic leukemia (AML type M3)

Front 6

Autosplenectomy

Back 6

Sickle cell anemia: switch a E6V in b chain
Low O2 Increased sickling
Aplastic crisis w/ B19 (Parvovirus ssDNA) infection
Salmonella osteomyelitis
Vaso-occlusive painful crisises
Hydroxyurea as Txt (­ HbF); Bone marrow transplant

Front 7

Babinski

Back 7

UMN lesion

Front 8

Basophilic Stippling of RBCs

Back 8

Lead poisoning

Front 9

Bence Jones Protein

Back 9

Multiple myeloma free light chains (either kappa or lambda)
Waldenstrom’s macroglobinemia

Front 10

Birbeck Granules

Back 10

Histiocytosis X (eosinophilic granuloma)

Front 11

Blue Bloater

Back 11

Chronic Bronchitis (at least 3 months for at least 2 years of ecessive mucus secretion & chronic recurrent productive cough)

Front 12

Boot-Shaped Heart

Back 12

Tetralogy of Fallot

Front 13

Bouchard’s Nodes

Back 13

Osteoarthritis (Proximal IP joint of the fingers)

Front 14

Boutonniere’s Deformity

Back 14

Rheumatoid arthritis flex proximal & extend distal IP joints

Front 15

Brown Tumor

Back 15

Hyperparathyroidism

Front 16

Brushfield Spots

Back 16

Down’s

Front 17

Call-Exner Bodies

Back 17

Granulosa cell tumor: associated w/ endometrial hyperplasia & carcinoma
Granuloma-Theca cell tumor

Front 18

Cardiomegaly with Apical Atrophy

Back 18

Chagas’ Disease

Front 19

Chancre

Back 19

1° Syphilis

Front 20

Chancroid

Back 20

Haemophilus ducreyi

Front 21

Charcot Triad

Back 21

Multiple sclerosis = nystagmus, intention tremor, scanning speech

Front 22

Charcot-Leyden Crystals

Back 22

Bronchial asthma

Front 23

Cheyne-Stokes Breathing

Back 23

Characterized by oscillation of ventilation between apnea and tachypnea with a crescendo-decrescendo pattern in the depth of respirations
Caused by damage to respiratory centers

Front 24

Chocolate Cysts

Back 24

Endometriosis

Front 25

Chvostek’s Sign

Back 25

Hypocalcemia facial spasm in tetany

Front 26

Clue Cells

Back 26

Gardnerella vaginitis

Front 27

Codman’s Triangle

Back 27

Osteosarcoma

Front 28

Cold Agglutinins

Back 28

Mycoplasma pneumoniae
Infectious mononucleosis

Front 29

Condyloma Lata

Back 29

2° Syphilis
New coffee flavor at Bagel & Bagel

Front 30

Cotton Wool Spots

Back 30

Puffy white spots in the retina caused by damaged nerve fibers due to ischemia-induced swelling
Most commonly associated with diabetes and HTN

Front 31

Councilman Bodies

Back 31

Dying hepatocytes – HepB

Front 32

Crescents In Bowman’s Capsule

Back 32

Rapidly progressive (crescentic) glomerulonephritis

Front 33

Currant-Jelly Sputum

Back 33

Klebsiella

Front 34

Curschmann’s Spirals

Back 34

Bronchial asthma

Front 35

Depigmentation Of Substantia Nigra

Back 35

Parkinson’s

Front 36

Donovan Bodies

Back 36

Granuloma inguinale (STD)

Front 37

Eburnation

Back 37

Osteoarthritis (polished, ivory-like appearance of bone)

Front 38

Ectopia Lentis

Back 38

Marfan’s

Front 39

Erythema Chronicum Migrans

Back 39

Lyme Disease

Front 40

Fatty Liver

Back 40

Alcoholism

Front 41

Ferruginous Bodies

Back 41

Asbestosis - & Iron laden

Front 42

Ghon Focus / Complex

Back 42

Tuberculosis (1° & 2°, respectively)

Front 43

Glitter Cells

Back 43

Acute Pyelonephritis

Front 44

Gower’s Maneuver

Back 44

Duchenne’s MD use of arms to stand

Front 45

Heberden’s Nodes

Back 45

Osteoarthritis (Distal IP joint of the fingers)

Front 46

Heinz Bodies

Back 46

G6PDH Deficiency

Front 47

Heterophil Antibodies

Back 47

Infectious mononucleosis (EBV)

Front 48

Hirano Bodies

Back 48

Alzheimer’s

Front 49

Hypersegmented PMNs

Back 49

Megaloblastic anemia

Front 50

Hypochromic Microcytic RBCs

Back 50

Iron-deficiency anemia or b Thalassemia

Front 51

Jarisch-Herxheimer Reaction

Back 51

Over-aggressive treatment of an asymptomatic pt. that leads to death of pathogen with concurrent release of toxins:
-Syphilis
-Bartonellosis
-Brucellosis
-Typhoid fever

Front 52

Joint Mice

Back 52

Osteoarthritis (fractured osteophytes)

Front 53

Kaussmaul Breathing

Back 53

Acidosis / Diabetic Ketoacidosis

Front 54

Keratin Pearls

Back 54

Squamous Cell CA of skin Actinic Keratosis is a precursor, lung CA, other squamous cell CA

Front 55

Keyser-Fleischer Ring

Back 55

Wilson’s

Front 56

Kimmelstiel-Wilson Nodules

Back 56

Diabetic nephropathy: Nodular Glomerulosclerosis nodules of mesangial matrix

Front 57

Koilocytes

Back 57

HPV 6 & 11 (condyloma acuminatum - benign) and HPV 16 & 18 (malignant association)

Front 58

Koplik Spots

Back 58

Measles

Front 59

Lewy Bodies

Back 59

Parkinson’s (eosinophilic inclusions in damaged substantia nigra cells)

Front 60

Lines of Zahn

Back 60

Thrombus in aorta or atria
Visible and microscopic laminations produced by alternating pale layers of platelets mixed with fibrin and darker layer containing red blood cells
Implies thrombus formation at site of rapid blood flow

Front 61

Lisch Nodules

Back 61

Neurofibromatosis (von Recklinhausen’s disease) = pigmented iris hamartomas

Front 62

Lumpy-Bumpy IF Glomeruli

Back 62

Poststreptococcal glomerulonephritis – prototype of nephritic syndrome

Front 63

Mallory Bodies

Back 63

Alcoholic hepatitis

Front 64

McBurney’s Sign

Back 64

Appendicitis (McBurney’s Point is 2/3 of the way from the umbilicus to anterior superior iliac spine)

Front 65

Michealis-Gutmann Bodies

Back 65

Malakoplakia lesion on bladder due to macros & calcospherites (M-G Bodies): usually due to E. Coli

Front 66

Monoclonal Antibody Spike

Back 66

Multiple myeloma this is called the M protein (usually IgG or IgA)
MGUS

Front 67

Myxedema

Back 67

Hypothyroidism

Front 68

Negri Bodies

Back 68

Rabies

Front 69

Neuritic Plaques

Back 69

Alzheimer’s

Front 70

Neurofibrillary Tangles

Back 70

Alzheimer’s

Front 71

Non-pitting Edema

Back 71

Myxedema
Anthrax Toxin

Front 72

Notching of Ribs

Back 72

Coarctation of Aorta

Front 73

Nutmeg Liver

Back 73

CHF = causing congested liver

Front 74

Owls Eye Cells

Back 74

CMV, EBV
Reed Sternburg Cells (Hodgkins Lymphoma)

Front 75

Painless Jaundice

Back 75

Pancreatic CA (head)

Front 76

Pannus

Back 76

Rheumatoid arthritis, also see morning stiffnes that increases w/ joint use, HLA-DR4

Front 77

Pautrier’s Microabscesses

Back 77

Mycosis fungoides (cutaneous T-cell lymphoma), Sezary

Front 78

Philadelphia Chromosome

Back 78

CML

Front 79

Pick Bodies

Back 79

Pick’s Disease

Front 80

2 types of COPD

Back 80

Pink Puffer – Type A: Emphysema
Blue Bloater – Type B: Bronchitis
Emphysema: Centroacinar – smoking; Panacinar - a1-antitrypsin deficiency

Front 81

Podagra

Back 81

Gout (MP joint of hallux)

Front 82

Port-Wine Stain

Back 82

Hemangioma

Front 83

Anterior Drawer Sign

Back 83

Tearing of the ACL

Front 84

Psammoma Bodies

Back 84

Papillary adenocarcinoma of the thyroid
Serous papillary cystadenocarcinoma of the ovary
Meningioma
Mesothelioma

Front 85

Pseudohypertrophy

Back 85

Seen w/ Duchenne muscular dystrophy
Calf muscles, due to fat deposition

Front 86

Punched-Out Bone Lesions

Back 86

Multiple myeloma

Front 87

Rash on Palms & Soles

Back 87

2° Syphilis
RMSF
Coxsackie virus infection: Hand-Foot-Mouth Disease

Front 88

Red Morning Urine

Back 88

Paroxysmal nocturnal hemoglobinuria. You would use Ham’s test to confirm.

Front 89

Reed-Sternberg Cells

Back 89

Hodgkin’s Disease

Front 90

Reid Index Increased

Back 90

Chronic bronchitis = increased ratio of bronchial gland to bronchial wall thickness
RI = gland/wall
Normal < 0.4

Front 91

Reinke Crystals

Back 91

Leydig cell tumor

Front 92

Rouleaux Formation

Back 92

Multiple myeloma RBC’s stacked as poker chips

Front 93

S3 Heart Sound

Back 93

L®R Shunt (VSD, PDA, ASD)
Mitral Regurg
LV Failure

Front 94

S4 Heart Sound

Back 94

Indicates atrial contraction against a ventricle with decreased compliance (e.g. hypetrophic ventricle, cor pulmonale, restrictive cardiomyopathy)

Front 95

Schwartzman Reaction

Back 95

Neisseria meningitidis impressive rash with bugs

Front 96

Smith Antigen

Back 96

SLE (also anti-dsDNA)
Malar Rash, Wire loop kidney lesions, Joint pain, False (+) syphilis test (VDRL)
90% 14-45 yo females
also seen w/ use of INH; Procainamide; Hydralazine = SLE-like syndrome

Front 97

Soap Bubble on X-Ray

Back 97

Giant cell tumor of bone

Front 98

Spike & Dome Glomeruli

Back 98

Membranous glomerulonephritis = Nephrotic syndrome
Spike = basement membrane material & Dome = immune complex deposits (IgG orC3)

Front 99

String Sign on X-ray

Back 99

Crohn’s bowel wall thickening

Front 100

Target Cells

Back 100

Thalassemia in a Thalassemia w/ no a gene: Hydrops Fetalis & Intrauterine death associations = HbBarts

Front 101

Tendinous Xanthomas

Back 101

Familial Hypercholesterolemia

Front 102

Thyroidization of Kidney

Back 102

Chronic pyelonephritis

Front 103

Tophi

Back 103

Gout

Front 104

Tram-Track Glomeruli

Back 104

Membranoproliferative GN: Nephritic syndrome – basement membrane is duplicated into 2 layers

Front 105

Trousseau’s Sign

Back 105

Visceral ca, classically pancreatic (migratory thrombophlebitis)
Hypocalcemia (carpal spasm)
These are two entirely different disease processes and different signs, but they unfortunately have the same name.

Front 106

Virchow’s Node

Back 106

Supraclavicular node enlargement by metastatic carcinoma of the stomach or other abdominal organ

Front 107

Warthin-Finkeldey Giant Cells

Back 107

Measles

Front 108

WBC Casts

Back 108

Pyelonephritis

Front 109

Whipple’s Triad

Back 109

1. Symptoms known or likely to be caused by hypoglycemia
2. A low plasma glucose measured at the time of the symptoms
3. Relief of symptoms when the glucose is raised to normal

Front 110

Wire Loop Glomeruli

Back 110

Lupus nephropathy, type IV (diffuse proliferative form)

Front 111

­ AFP in amniotic fluid or mother’s serum

Back 111

Spina Bifida
Anencephaly

Front 112

­ Uric Acid

Back 112

Gout
Lesch Nyhan
Myeloproliferative Disorders
Diuretics (Loop & Thiazides)

Front 113

Increased FEV1/FVC

Back 113

COPD

Front 114

“Ground Glass” on chest x-ray (Hyaline)

Back 114

Due to Pneumocystis carinii
Seen w/ Atelectasia

Front 115

Honey Combing of the lung

Back 115

Pulmonary fibrosis; restrictive lung disease

Can be associated with DIP, UIP, interstitial pneumonitis associated with collagen vascular diseases, asbestosis, berylliosis, sarcoidosis, LIP, DAD, recurrent aspiration, allergic alveolitis, and idiopathic

Front 116

Crescents

Back 116

Goodpastures syndrome (pneumonia w/ hemoptysis & rapidly progressive glomerulonephritis)

Front 117

Linear Ig Deposits

Back 117

Goodpastures syndrome

Front 118

45 Degree Branch Points

Back 118

Aspergillosis

Front 119

PAS(+) Dutcher Bodies

Back 119

Waldenstrom’s Macroglobulinemia = ­IgM = Hyperviscosity

Front 120

“Ground Glass” in Abdomen(Hyaline)

Back 120

Seen in the hepatocytes of healthy carriers of HBsAg in liver biopsies

Front 121

“Signet Ring” Cells

Back 121

Cells that replace the ovaries, due to Krukenberg’s tumor that has metastasized from the stomach

Front 122

Ground Glass Appearance (Hyaline)

Back 122

Seen w/ Progressive Multifocal Leukoencephalopathy oligodendrocytes
Nuclei seen in Papillary CA of the thyroid (malignant)

Front 123

Congo Red

Back 123

Shows amyloid deposition in plaques & vascular walls

Front 124

Meningiomas & Progesterone

Back 124

Some meningiomas have Progesterone receptors = rapid growth in pregnancy can occur

Front 125

Tuberous Sclerosis Triad

Back 125

Seizures; Mental retardation; Leukoderma (congenital facial white spots or macules): angiofibromas

Front 126

Cowdry A Inclusions

Back 126

Seen w/ Herpes Simplex Encephalitis – in oligodendroglia

Front 127

Devic’s Syndrome

Back 127

“Neuromyelitis Optica”
A variant of multiple sclerosis: rapid demyelination of the optic nerve & spinal cord w/ paraplegia

Front 128

c-erb B2

Back 128

Breast Cancer association

Front 129

Foster-Kennedy Syndrome

Back 129

The syndrome is defined as the following changes:
-optic atrophy
-papilledema in the opposite eye
-Central scotoma in the same eye
-anosmia on the same side

Caused by optic nerve and olfactory nerve compression, and increased ICP
Usually due to olfactory groove meningioma

Front 130

Hoffman’s Sign

Back 130

Flicking of the middle finger’s nail elicits flexion of thumb or second digit
Indicates UMN lesion
Upper limb equivalent of Babinski sign

Front 131

Red Nucleus Destruction

Back 131

Intention tremors of the arm

Front 132

Ventral Spinocerebellar tr.

Back 132

Unconscious proprioception of lower extremities

Front 133

Dorsal Spinocerebellar tr.

Back 133

Unconscious prorpioception & fine motor movements

Front 134

Cuneocerebellar tr.

Back 134

Unconscious proprioception & fine motor movements of upper extremities

Front 135

Dorsal Column

Back 135

Conscious proprioception of the body

Front 136

Lateral Spinothalamic tr.

Back 136

Pain & Temperature sensation

Front 137

Ventral Spinothalamic tr.

Back 137

Light touch perception

Front 138

SVA

Back 138

Taste & Smell

Front 139

GSE

Back 139

Muscles of the eye & of the tongue

Front 140

SSA

Back 140

Vision; Hearing; Equilibrium

Front 141

GVA

Back 141

Sensation of tongue; soft palate. Carotid Body & Sinus innervation

Front 142

GVE

Back 142

Edinger Westphal = parasympathetic eye innervation
Gland innervation = secretions
Viscera

Front 143

GSA

Back 143

Pain & temperature of face
Sensation of external ear

Front 144

SVE

Back 144

Innervation of muscles of masticaiton, facial expressions, larynx & pharynx

Front 145

LMN Lesion

Back 145

Werndig Hoffman (progressive infantile muscular atrophy)
Poliomyelitis

Front 146

Sensory Pathway Lesion

Back 146

Subacute Combined Degeneration = Friedrich’s Ataxia = B12 deficiency
Tabes Dorsalis (Neurosyphilis)

Front 147

Both UMN & LMN Lesion

Back 147

ALS = Lou Gherig’s Disease

Front 148

Both Sensory & Motor Lesion

Back 148

Brown Sequard
Anterior Spinal artery Occlusion

Front 149

Suprachiasmatic Nucleus

Back 149

Controls circadian rhythm

Front 150

Ventromedial Nucleus

Back 150

Satiety center. Savage behavior & obesity when lesioned

Front 151

Lateral Nucleus

Back 151

Induces eating. Starvation when lesioned

Front 152

Arcuate Nucleus

Back 152

Releases PIF (dopa-ergic neurons)

Front 153

Mamillary Body

Back 153

Can have hemorrhages as seen in Wernicke’s Encephalopathy

Front 154

Acanthocytes

Back 154

RBSc w/ spiny projections. Seen in Abetalipoproteinemia, liver disease, McLeod syndrome.