Global institute of medical sciences http://www.gims-org.com Dr.G.Bhanu Prakash

1. www.gims-org.com

2. CLINICAL FINDINGS U SHOULD KNOW MUST
Term Definitions
"Bamboo spine" on x-ray -- CF Ankylosing spondylitis
"Blue bloater" -- CF Chronic bronchitis
Hemorrhage causes brown color of osteolytic cysts:
"Brown tumor" of bone -- CF 1. Hyperparathyroidism; 2. Osteitis fibrosa cystica
(von Recklinghausen's disease)
"Chocolate cysts" -- CF Endometriosis (frequently involves both ovaries)
"Lumpy-bumpy" appearance of
Poststreptococcal glomerulonephritis
glomeruli on immunofluorescence -- CF
"Machine-like" murmur -- MF cause PDA
"Orphan Annie" nuclei -- CF Papillary carcinoma of the thyroid
Emphysema (centroacinar [smoking], panacinar [α1-
"Pink puffer" -- CF
antitrypsin deficiency])
"Smudge cell" -- CF CLL
"Strawberry tongue" -- CF Scarlet fever
"Tram-track" appearance on LM -- CF Membranoproliferative glomerulonephritis
"Wire loop" appearance on LM -- CF Lupus nephropathy
Berry aneurysm––associated with adult polycystic
"Worst headache of my life" -- CF
kidney disease
Actinic keratosis -- CF Often precedes squamous cell carcinoma
Autoimmune (infection is the 2nd most common
Addison's -- MF cause
cause)
Addison's disease -- CF 1° adrenocortical deficiency
Polyostotic fibrous dysplasia, precocious puberty,
Albright's syndrome -- CF
café-au-lait spots, short stature, young girls
Guillain-Barré (incr protein in CSF with only modest
Albuminocytologic dissociation -- CF
incr in cell count)
Alport's syndrome -- CF Hereditary nephritis with nerve deafness
Aneurysm, dissecting -- MF cause Hypertension
Anti–basement membrane antibodies --
Goodpasture's syndrome
CF
Anticentromere antibodies -- CF Scleroderma (CREST)
Anti-double-stranded DNA antibodies
SLE (type III hypersensitivity)
(ANA antibodies) -- CF
Anti–epithelial cell antibodies -- CF Pemphigus vulgaris
Antigliadin antibodies -- CF Celiac disease
Antihistone antibodies -- CF Drug-induced SLE
Anti-IgG antibodies -- CF Rheumatoid arthritis
Antimitochondrial antibodies -- CF 1° biliary cirrhosis

3. Antineutrophil antibodies -- CF Vasculitis
Antiplatelet antibodies -- CF Idiopathic thrombocytopenic purpura
Aortic aneurysm, abdominal and
Atherosclerosis
descending aorta -- MF cause
Aortic aneurysm, ascending -- MF cause3° syphilis
Arachnodactyly -- CF Marfan's syndrome
Argyll Robertson pupil -- CF Neurosyphilis
Arnold-Chiari malformation -- CF Cerebellar tonsillar herniation
Aschoff bodies -- CF Rheumatic fever
Atrophy of the mammillary bodies -- CFWernicke's encephalopathy
Acute myelogenous leukemia (especially the
Auer rods -- CF
promyelocytic type)
Autosplenectomy -- CF Sickle cell anemia
Babinski's sign -- CF UMN lesion
Bacteremia/pneumonia (IVDA) -- MC S. aureus
Bacteria associated with cancer -- MC H. pylori
Bacteria found in GI tract -- MC Bacteroides (2nd most common is E. coli )
Bacterial meningitis (adults) -- MF
Streptococcus pneumoniae
cause
Bacterial meningitis (elderly) -- MF
S. pneumoniae
cause
Bacterial meningitis (kids) -- MF cause S. pneumoniae or Neisseria meningitidis
Bacterial meningitis (newborns) -- MF
Group B streptococcus
cause
Baker's cyst in popliteal fossa -- CF Rheumatoid arthritis
Bartter's syndrome -- CF Hyperreninemia
Basophilic stippling of RBCs -- CF Lead poisoning
Becker's muscular dystrophy -- CF Defective dystrophin; less severe than Duchenne's
Bell's palsy -- CF LMN CN VII palsy
Multiple myeloma (kappa or lambda Ig light chains
Bence Jones proteins -- CF
in urine), Waldenström's macroglobulinemia (IgM)
Berger's disease -- CF IgA nephropathy
Bernard-Soulier disease -- CF Defect in platelet adhesion
Bilateral hilar adenopathy, uveitis -- CF Sarcoidosis
Birbeck granules on EM -- CF Histiocytosis X (eosinophilic granuloma)
Bloody tap on LP -- CF Subarachnoid hemorrhage
Blue sclera -- CF Osteogenesis imperfecta
Blue-domed cysts -- CF Fibrocystic change of the breast
Boot-shaped heart on x-ray -- CF Tetralogy of Fallot; RVH
Bouchard's nodes -- CF Osteoarthritis (PIP swelling 2° to osteophytes)
Boutonnière deformity -- CF Rheumatoid arthritis
Mets > astrocytoma (including glioblastoma
Brain tumor (adults) -- MC
multiforme) > meningioma > schwannoma
Brain tumor (kids) -- MC Medulloblastoma (cerebellum)
Brain tumor––supratentorial (kids) --
Craniopharyngioma
MC
Branching rods in oral infection -- CF Actinomyces israelii
Infiltrating ductal carcinoma (in the United States, 1
Breast cancer -- MC
in 9 women will develop breast cancer)
Breast mass -- MC Fibrocystic change (in postmenopausal women,

4. carcinoma is the most common)
Breast tumor (benign) -- MC Fibroadenoma
Bruton's disease -- CF X-linked agammaglobulinemia
Budd-Chiari syndrome -- CF Posthepatic venous thrombosis
Buerger's disease -- CF Small/medium-artery vasculitis
Bug in debilitated, hospitalized
Klebsiella
pneumonia patient -- MC
t8:14; associated with EBV; "starry sky" appearance
Burkitt's lymphoma -- CF
on histology
Burton's lines -- CF Lead poisoning
Café-au-lait spots on skin -- CF Neurofibromatosis
Caisson disease -- CF Gas emboli
Calf pseudohypertrophy -- CF Duchenne's muscular dystrophy
Call-Exner bodies -- CF Granulosa-theca cell tumor of the ovary
c-ANCA, p-ANCA -- CF Wegener's granulomatosis, microscopic polyangiitis
Cancer associated with AIDS -- MF
Kaposi's sarcoma
cause
Cardiac 1° tumor (adults) -- MC Myxoma (4:1 left to right atrium; "ball and valve")
Cardiac 1° tumor (kids) -- MC Rhabdomyoma
Cardiac tumor (adults) -- MC Mets
Cardiomegaly with apical atrophy -- CF Chagas' disease
Cardiomyopathy -- MC Dilated cardiomyopathy
Cerebriform nuclei -- CF Mycosis fungoides (cutaneous T-cell lymphoma)
Chagas' disease -- CF Trypanosome infection
Chancre -- CF 1° syphilis (not painful)
Chancroid -- CF Haemophilus ducreyi (painful)
Multiple sclerosis (nystagmus, intention tremor,
Charcot's triad -- CF scanning speech), cholangitis (jaundice, RUQ pain,
fever)
Charcot-Leyden crystals -- CF Bronchial asthma (eosinophil membranes)
Chédiak-Higashi disease -- CF Phagocyte deficiency
Tay-Sachs, Niemann-Pick disease, central retinal
Cherry-red spot on macula -- CF
artery occlusion
respirations Central apnea in CHF and incr
Cheyne-Stokes -- CF
intracranial pressure
Down syndrome (associated with ALL, Alzheimer's
Chromosomal disorder -- MC
dementia, and endocardial cushion defects)
Atrial fibrillation (associated with high risk of
Chronic arrhythmia -- MC
emboli)
Chronic atrophic gastritis -- CF Predisposition to gastric carcinoma
Chvostek's sign -- CF Hypocalcemia (facial muscle spasm upon tapping)
Clear cell adenocarcinoma of the vagina
DES exposure in utero
-- CF
Clue cells -- CF Gardnerella vaginitis
Codman's triangle on x-ray -- CF Osteosarcoma
Cold agglutinins -- CF Mycoplasma pneumoniae, infectious mononucleosis
Cold intolerance -- CF Hypothyroidism
Condylomata lata -- CF 2° syphilis
Congenital adrenal hyperplasia -- MF
21-hydroxylase deficiency
cause

5. Congenital cardiac anomaly -- MC VSD
Constrictive pericarditis -- MC Tuberculosis
Continuous machinery murmur -- CF Patent ductus arteriosus
Cori's disease -- CF Debranching enzyme deficiency
Coronary artery involved in thrombosis
LAD > RCA > LCA
-- MC
Cotton-wool spots -- CF Chronic hypertension
Cough, conjunctivitis, coryza + fever --
Measles
CF
Councilman bodies -- CF Toxic or viral hepatitis
Cowdry type A bodies -- CF Herpes virus
Crescents in Bowman's capsule -- CF Rapidly progressive crescentic glomerulonephritis
Cretinism -- MF cause Iodine deficit/hypothyroidism
Crigler-Najjar syndrome -- CF Congenital unconjugated hyperbilirubinemia
Curling's ulcer -- CF Acute gastric ulcer associated with severe burns
Currant-jelly sputum -- CF Klebsiella
Curschmann's spirals -- CF Bronchial asthma (whorled mucous plugs)
Corticosteroid therapy (2nd most common cause is
Cushing's syndrome -- MF cause
excess ACTH secretion by pituitary)
Cushing's ulcer -- CF Acute gastric ulcer associated with CNS injury
Tetralogy of Fallot, transposition of great vessels,
Cyanosis (early; less common) -- MC
truncus arteriosus
VSD, ASD, PDA (close with indomethacin; open
Cyanosis (late; more common) -- MC
with misoprostol)
D-dimers -- CF DIC
Death in CML -- MF cause Blast crisis
Death in SLE -- MF cause Lupus nephropathy
Dementia -- MF cause Alzheimer's (2nd most common is multi-infarct)
Demyelinating disease -- MC Multiple sclerosis
Depigmentation of neurons substantia in Parkinson's disease (basal ganglia disorder––
nigra -- CF rigidity, resting tremor, bradykinesia)
Dermatitis, dementia, diarrhea -- CF Pellagra (niacin, vitamin B3 deficiency)
Gram-negative sepsis, obstetric complications,
DIC -- MF cause
cancer, burn trauma
Dietary deficit -- MC Iron
Dog or cat bite -- CF Pasteurella multocida
Donovan bodies -- CF Granuloma inguinale
Dressler's syndrome -- CF Post-MI fibrinous pericarditis
Congenital conjugated hyperbilirubinemia (black
Dubin-Johnson syndrome -- CF
liver)
Duchenne's muscular dystrophy -- CF Deleted dystrophin gene (X-linked recessive)
Osteoarthritis (polished, ivory-like appearance of
Eburnation -- CF
bone)
Trisomy 18 associated with rocker-bottom feet, low-
Edwards' syndrome -- CF
set ears, heart disease
Late cyanosis shunt (uncorrected L -> R shunt
Eisenmenger's complex -- CF
becomes R -> L shunt)
Ejection click -- MF cause Aortic/pulmonic stenosis
Elastic skin -- CF Ehlers-Danlos syndrome
Epiglottitis -- MC Haemophilus influenzae type B

6. Superior trunk (C5–C6) brachial plexus injury
Erb-Duchenne palsy -- CF
("waiter's tip")
Erythema chronicum migrans -- CF Lyme disease
Esophageal cancer -- MC Squamous cell carcinoma
Fanconi's syndrome -- CF Proximal tubular reabsorption defect
Fat, female, forty, and fertile -- CF Acute cholecystitis
Fatty liver -- CF Alcoholism
Ferruginous bodies -- CF Asbestosis
Food poisoning -- MF cause S. aureus
Gardner's syndrome -- CF Colon polyps with osteomas and soft tissue tumors
Gaucher's disease -- CF Glucocerebrosidase deficiency
Gene involved in cancer -- MC p53 tumor suppressor gene
Ghon focus -- CF 1° TB
Gilbert's syndrome -- CF Benign congenital unconjugated hyperbilirubinemia
Glanzmann's thrombasthenia -- CF Defect in platelet aggregation
Glomerulonephritis (adults) -- MF cause IgA nephropathy (Berger's disease)
Autoantibodies against alveolar and glomerular
Goodpasture's syndrome -- CF
basement membrane proteins
Duchenne's (use of patient's arms to help legs pick
Gowers' maneuver -- CF
self off the floor)
Caucasians (fat-soluble vitamin deficiencies, mucous
Group affected by cystic fibrosis -- MC
plugs/lung infections)
Guillain-Barré syndrome -- CF Idiopathic polyneuritis
Gynecologic malignancy -- MC Endometrial carcinoma
Hair-on-end (crew-cut) appearance on B-thalassemia, sickle cell anemia (extramedullary
x-ray -- CF hematopoiesis)
Diabetes insipidus + exophthalmos +
Hand-Schüller-christian disease
lesions of skull -- CF
Hand-Schüller-christian disease -- CF Chronic progressive histiocytosis
HbF -- CF Thalassemia major
HbS -- CF Sickle cell anemia
Choriocarcinoma, hydatidiform mole (occurs with
hCG elevated -- CF
and without embryo)
Heart murmur -- MC Mitral valve prolapse
Heart valve (rheumatic fever) -- MC Mitral valve (aortic is 2nd)
Heart valve in bacterial endocarditis --
Mitral
MC
Heart valve in bacterial endocarditis in
Tricuspid
IVDA -- MC
Heberden's nodes -- CF Osteoarthritis (DIP swelling 2° to osteophytes)
Heinz bodies -- CF G6PD deficiency
Enterobius vermicularis (Ascaris lumbricoides is 2nd
Helminth infection (U.S.) -- MC
most common)
Rupture of middle meningeal artery (arterial
Hematoma––epidural -- MF cause
bleeding is fast)
Rupture of bridging veins (trauma; venous bleeding
Hematoma––subdural -- MF cause
is slow)
Multiple blood transfusions (can result in CHF and
Hemochromatosis -- MF cause
incr risk of hepatocellular carcinoma)
Henoch-Schönlein purpura -- CF Hypersensitivity vasculitis associated with

7. hemorrhagic urticaria and URIs
Hepatic cirrhosis -- MF cause EtOH
Cirrhotic liver (often associated with hepatitis B and
Hepatocellular carcinoma -- MF cause
C)
Hereditary bleeding disorder -- MC von Willebrand's
Heterophil antibodies -- CF Infectious mononucleosis (EBV)
High-output cardiac failure (dilated
Wet beriberi (thiamine, vitamin B1 deficiency)
cardiomyopathy) -- CF
HLA-B27 -- CF Reiter's syndrome, ankylosing spondylitis
DM type 1 (caused by autoimmune destruction of B
HLA-DR3 or -DR4 -- CF
cells)
Holosystolic murmur -- MF cause VSD, tricuspid regurgitation, mitral regurgitation
Homer Wright rosettes -- CF Neuroblastoma
Honeycomb lung on x-ray -- CF Interstitial fibrosis
Horner's syndrome -- CF Ptosis, miosis, and anhidrosis
Howell-Jolly bodies -- CF Splenectomy (or nonfunctional spleen)
Huntington's disease -- CF Caudate degeneration (autosomal dominant)
Hyperphagia + hypersexuality +
Klüver-Bucy syndrome (amygdala)
hyperorality + hyperdocility -- CF
Hyperpigmentation of skin -- CF 1° adrenal insufficiency (Addison's disease)
Hypersegmented neutrophils -- CF Macrocytic anemia
Hypertension + hypokalemia -- CF Conn's syndrome
Hypertension, 2° -- MF cause Renal disease
Hypochromic microcytosis -- CF Iron deficiency anemia, lead poisoning
Hypoparathyroidism -- MF cause Thyroidectomy
Hypopituitarism -- MF cause Adenoma
Gout, Lesch-Nyhan syndrome, myeloproliferative
Increased uric acid levels -- CF
disorders, loop and thiazide diuretics
Increased α-fetoprotein in amniotic
Anencephaly, spina bifida (neural tube defects)
fluid/maternal serum -- CF
Infection in blood transfusion -- MF
Hepatitis C
cause
Infection in burn victims -- MF cause Pseudomonas
Intussusception -- CF Adenovirus (causes hyperplasia of Peyer's patches)
Janeway lesions -- CF Endocarditis
Syphilis––overaggressive treatment of an
Jarisch-Herxheimer reaction -- CF asymptomatic patient that causes symptoms due to
rapid lysis
Job's syndrome -- CF Neutrophil chemotaxis abnormality
Kaposi's sarcoma -- CF AIDS in MSM (men who have sex with men)
Kartagener's syndrome -- CF Dynein defect
Kayser-Fleischer rings -- CF Wilson's disease
Keratin pearls -- CF Squamous cell carcinoma
Calcium = radiopaque (2nd most common is
ammonium = radiopaque; formed by urease-positive
Kidney stones -- MC
organisms such as Proteus vulgaris or
Staphylococcus)
Kimmelstiel-Wilson nodules -- CF Diabetic nephropathy
Klüver-Bucy syndrome -- CF Bilateral amygdala lesions
Koilocytes -- CF HPV

8. Koplik spots -- CF Measles
Krukenberg tumor -- CF Gastric adenocarcinoma with ovarian metastases
Kussmaul hyperpnea -- CF Diabetic ketoacidosis
Lens dislocation + aortic dissection +
Marfan's syndrome (fibrillin deficit)
joint hyperflexibility -- CF
Lesch-Nyhan syndrome -- CF HGPRT deficiency
Leukemia (adults) -- MF cause AML
Lewy bodies -- CF Parkinson's disease
Libman-Sacks disease -- CF Endocarditis associated with SLE
Lines of Zahn -- CF Arterial thrombus
Lisch nodules -- CF Neurofibromatosis (von Recklinghausen's disease)
Liver disease -- MC Alcoholic liver disease
Location of brain tumors (adults) -- MC Supratentorial
Location of brain tumors (kids) -- MC Infratentorial
Low serum ceruloplasmin -- CF Wilson's disease
Lucid interval -- CF Epidural hematoma
Lysosomal storage disease -- MC Gaucher's disease
Lytic bone lesions on x-ray -- CF Multiple myeloma
Male cancer -- MC Prostatic carcinoma
Malignancy associated with
Hodgkin's disease
noninfectious fever -- MC
Malignant skin tumor -- MC Basal cell carcinoma (rarely metastasizes)
Mallory bodies -- CF Alcoholic liver disease
Mallory-Weiss syndrome -- CF Esophagogastric lacerations
McArdle's disease -- CF Muscle phosphorylase deficiency
McBurney's sign -- CF Appendicitis
Down syndrome (fragile X is the 2nd most common
Mental retardation -- MF cause
cause)
Mets to bone -- MC Breast, lung, thyroid, testes, prostate, kidney
Lung, breast, skin (melanoma), kidney (renal cell
Mets to brain -- MC
carcinoma), GI
Colon, gastric, pancreatic, breast, and lung
Mets to liver -- MC
carcinomas
MI -- MF cause Atherosclerosis
Mitral valve stenosis -- MF cause Rheumatic heart disease
MLF syndrome (INO) -- CF Multiple sclerosis
Multiple myeloma (called the M protein; usually IgG
or IgA), MGUS (monoclonal gammopathy of
Monoclonal antibody spike -- CF
undetermined significance), Waldenström's (M
protein = IgM) macroglobulinemia
Motor neuron disease -- MC ALS
Myocarditis -- MF cause Coxsackie B
Myxedema -- CF Hypothyroidism
Necrotizing vasculitis (lungs) and Wegener's and Goodpasture's (hemoptysis and
necrotizing glomerulonephritis -- CF glomerular disease)
Needle-shaped, negatively birefringent
Gout
crystals -- CF
Negri bodies -- CF Rabies
ALL (2nd most common is cerebellar
Neoplasm (kids) -- MC
medulloblastoma)

9. Nephritis + cataracts + hearing loss --
Alport's syndrome
CF
Nephrotic syndrome -- MC Membranous glomerulonephritis
Nephrotic syndrome (adults) -- MF
Membranous glomerulonephritis
cause
Minimal change disease (associated with
Nephrotic syndrome (kids) -- MF cause
infections/vaccinations; treat with corticosteroids)
Neurofibrillary tangles -- CF Alzheimer's disease
Niemann-Pick disease -- CF Sphingomyelinase deficiency
No lactation postpartum -- CF Sheehan's syndrome (pituitary infarction)
Nutmeg liver -- CF CHF
Obstruction of male urinary tract -- MC BPH
Occupational exposure to asbestos -- CF Malignant mesothelioma
Opening snap -- MF cause Mitral stenosis
Opportunistic infection in AIDS -- MC Pneumocystis carinii pneumonia
Organ receiving mets -- MC Adrenal glands (due to rich blood supply)
Organ sending mets -- MC Lung > breast, stomach
Osler's nodes -- CF Endocarditis
Osteomyelitis -- MF cause S. aureus
Osteomyelitis in patients with sickle cell
Salmonella
disease -- MF cause
Osteomyelitis with IVDA -- MF cause Pseudomonas
Ovarian tumor (benign) -- MC Serous cystadenoma
Ovarian tumor (malignant) -- MC Serous cystadenocarcinoma
Owl's eye -- CF CMV
Painless jaundice -- CF Pancreatic cancer (head)
Palpable purpura on legs and buttocks --
Henoch-Schönlein purpura
CF
Bronchogenic apical tumor associated with Horner's
Pancoast's tumor -- CF
syndrome
Pancreatic tumor -- MC Adenocarcinoma (head of pancreas)
Pancreatitis (acute) -- MF cause EtOH and gallstones
Pancreatitis (chronic) -- MF cause EtOH (adults), cystic fibrosis (kids)
Pannus -- CF Rheumatoid arthritis
Parkinson's disease -- CF Nigrostriatal dopamine depletion
Patient with ALL/CLL/AML/CML -- ALL—child, CLL—adult > 60, AML—adult > 60,
MC CML—adult 35–50
Patient with Hodgkin's -- MC Young male (except nodular sclerosis type––female)
Patient with minimal change disease --
Young child
MC
Patient with Reiter's -- MC Male
Peau d'orange -- MF cause Carcinoma of the breast
Periosteal elevation on x-ray -- CF Pyogenic osteomyelitis
Peutz-Jeghers syndrome -- CF Benign polyposis
Peyronie's disease -- CF Penile fibrosis
Philadelphia chromosome (bcr-abl ) --
CML (may sometimes be associated with AML)
CF
Pick bodies -- CF Pick's disease
Pick's disease -- CF Progressive dementia, similar to Alzheimer's
PID -- MF cause Neisseria gonorrhoeae (monoarticular arthritis)

10. Prolactinoma (2nd––somatotropic "acidophilic"
Pituitary tumor -- MC
adenoma)
Plummer-Vinson syndrome -- CF Esophageal webs with iron deficiency anemia
Pneumonia in cystic fibrosis, burn
Pseudomonas aeruginosa
infection -- MF cause
Pneumonia, hospital-acquired -- MF
Klebsiella
cause
Podagra -- CF Gout (MP joint of hallux)
Podocyte fusion -- CF Minimal change disease
Polyneuropathy preceded by GI or
Guillain-Barré syndrome
respiratory infection -- CF
Polyneuropathy, cardiac pathology, and
WET beriberi (thiamine, vitamin B1 deficiency)
edema -- CF
Lysosomal glucosidase deficiency associated with
Pompe's disease -- CF
cardiomegaly
Port-wine stain -- CF Hemangioma
Positive anterior "drawer sign" -- CF Anterior cruciate ligament injury
Pott's disease -- CF Vertebral tuberculosis
Preventable blindness -- MF cause Chlamydia
Preventable cancer -- MC Lung cancer
Primary amenorrhea -- MF cause Turner's (XO)
Primary bone tumor (adults) -- MC Multiple myeloma
Primary hyperaldosteronism -- MF
Adenoma of adrenal cortex
cause
Adenomas (followed by hyperplasia, then
Primary hyperparathyroidism -- MC
carcinoma)
Primary hyperparathyroidism -- MF
Adenoma
cause
Primary liver tumor -- MC Hepatoma
Pseudopalisade tumor cell arrangement
Glioblastoma multiforme
-- CF
Pseudorosettes -- CF Ewing's sarcoma
Ptosis, miosis, anhidrosis -- CF Horner's syndrome (Pancoast's tumor)
Pulmonary hypertension -- MF cause COPD
Rash on palms and soles -- CF 2° syphilis, Rocky Mountain spotted fever
Raynaud's syndrome -- CF Recurrent vasospasm in extremities
RBC casts in urine -- CF Acute glomerulonephritis
Recurrent pulmonary Pseudomonas and
Cystic fibrosis
S. aureus infections -- CF
Red urine in the morning -- CF Paroxysmal nocturnal hemoglobinuria
Reed-Sternberg cells -- CF Hodgkin's lymphoma
Reid index (increased) -- CF Chronic bronchitis
Reinke crystals -- CF Leydig cell tumor
Reiter's syndrome -- CF Urethritis, conjunctivitis, arthritis
Renal cell carcinoma + cavernous
von Hippel–Lindau disease
hemangiomas + adenomas -- CF
Renal epithelial casts in urine -- CF Acute toxic/viral nephrosis
Renal cell carcinoma––associated with von Hippel–
Renal tumor -- MC Lindau and acquired polycystic kidney disease;
paraneoplastic syndromes (erythropoietin, renin,

11. PTH, ACTH)
Rhomboid crystals, positively
Pseudogout
birefringent -- CF
Rib notching -- CF Coarctation of aorta
Right heart failure due to a pulmonary
Cor pulmonale
cause -- MF cause
Right-sided heart failure -- MF cause Left-sided heart failure
Roth's spots in retina -- CF Endocarditis
Rotor's syndrome -- CF Congenital conjugated hyperbilirubinemia
Rouleaux formation (RBCs) -- CF Multiple myeloma
Left-to-right shunt (VSD, PDA, ASD), mitral
S3 -- CF
regurgitation, LV failure (CHF)
S4 -- CF Aortic stenosis, hypertrophic subaortic stenosis
Schiller-Duval bodies -- CF Yolk sac tumor
Secondary hyperparathyroidism -- MC Hypocalcemia of chronic renal failure
Senile plaques -- CF Alzheimer's disease
Sexually transmitted disease -- MC Chlamydia
Sézary syndrome -- CF Cutaneous T-cell lymphoma
Sheehan's syndrome -- CF Postpartum pituitary necrosis
Sheehan's syndrome -- MF cause Postpartum pituitary infarction 2° to hemorrhage
Shwartzman reaction -- CF Neisseria meningitidis
SIADH -- MF cause Small cell carcinoma of the lung
Signet-ring cells -- CF Gastric carcinoma
Simian crease -- CF Down syndrome
Sipple's syndrome -- CF MEN type IIa
Site of diverticula -- MC Sigmoid colon
Site of metastasis -- MC Regional lymph nodes
Site of metastasis (2nd most common) --
Liver
MC
Sites of atherosclerosis -- MC Abdominal aorta > coronary > popliteal > carotid
Sjögren's syndrome -- CF Dry eyes, dry mouth, arthritis
Skin cancer -- MC Basal cell carcinoma
Skip lesions -- CF Crohn's
Slapped cheeks -- CF Erythema infectiosum (fifth disease)
Smith antigen -- CF SLE
Soap bubble on x-ray -- CF Giant cell tumor of bone
Spike and dome on EM -- CF Membranous glomerulonephritis
Spitz nevus -- CF Benign juvenile melanoma
Splinter hemorrhages in fingernails --
Endocarditis
CF
Starry-sky pattern -- CF Burkitt's lymphoma
Stomach cancer -- MC Adenocarcinoma
Streaky ovaries -- CF Turner's syndrome
String sign on x-ray -- CF Crohn's disease
Subepithelial humps on EM -- CF Poststreptococcal glomerulonephritis
Suboccipital lymphadenopathy -- CF Rubella
Sulfur granules -- CF Actinomyces israelii
Scurvy (ascorbic acid, vitamin C deficiency)––
Swollen gums, bruising, poor wound
vitamin C is necessary for hydroxylation of proline
healing, anemia -- CF
and lysine in collagen synthesis

12. Systolic ejection murmur (crescendo-
Aortic valve stenosis
decrescendo) -- CF
t(14;18) -- CF Follicular lymphomas (bcl-2 activation)
t(8;14) -- CF Burkitt's lymphoma (c-myc activation)
t(9;22) -- CF Philadelphia chromosome, CML (bcr-abl hybrid)
Tabes dorsalis -- CF 3° syphilis
Tendon xanthomas (classically
Familial hypercholesterolemia
Achilles) -- CF
Testicular tumor -- MC Seminoma
Thumb sign on lateral x-ray -- CF Epiglottitis (Haemophilus influenzae)
Thyroid cancer -- MC Papillary carcinoma
Thyroidization of kidney -- CF Chronic bacterial pyelonephritis
Tophi -- CF Gout
Lower esophagus joins trachea/upper esophagus––
Tracheoesophageal fistula -- MC
blind pouch
Visceral cancer, pancreatic adenocarcinoma
Trousseau's sign -- CF (migratory thrombophlebitis), hypocalcemia (carpal
spasm)
Tumor in men -- MC Prostate carcinoma
Tumor in women -- MC Leiomyoma (estrogen dependent)
Tumor of infancy -- MC Hemangioma
Tumor of the adrenal medulla (adults) --
Pheochromocytoma (benign)
MC
Tumor of the adrenal medulla (kids) --
Neuroblastoma (malignant)
MC
Nodular sclerosis (vs. mixed cellularity, lymphocytic
Type of Hodgkin's -- MC
predominance, lymphocytic depletion)
Type of non-Hodgkin's -- MC Follicular, small cleaved
Type of pituitary adenoma -- MC Prolactinoma
UTI -- MF cause E. coli
UTI (young women) -- MF cause E. coli and Staphylococcus saprophyticus
Temporal arteritis (risk of ipsilateral blindness due to
Vasculitis -- MC
thrombosis of ophthalmic artery)
Viral encephalitis -- MC HSV
Left supraclavicular node enlargement from
Virchow's node -- CF
metastatic carcinoma of the stomach
Pulmonary embolism (triad = blood stasis,
Virchow's triad -- CF
endothelial damage, hypercoagulation)
Folic acid (pregnant women are at high risk; body
Vitamin deficiency (U.S.) -- MC
stores only 3- to 4-month supply)
von Recklinghausen's disease -- CF Neurofibromatosis with café-au-lait spots
von Recklinghausen's disease of bone --
Osteitis fibrosa cystica ("brown tumor")
CF
Wallenberg's syndrome -- CF PICA thrombosis
Waterhouse-Friderichsen syndrome -- Adrenal hemorrhage associated with
CF meningococcemia
Waxy casts -- CF Chronic end-stage renal disease
WBC casts in urine -- CF Acute pyelonephritis
WBCs in urine -- CF Acute cystitis
Wermer's syndrome -- CF MEN type I

13. Malabsorption syndrome caused by Tropheryma
Whipple's disease -- CF
whippelii
Wilson's disease -- CF Hepatolenticular degeneration
Xanthochromia (CSF) -- CF Subarachnoid hemorrhage
Xerostomia + arthritis +
Sjögren's syndrome
keratoconjunctivitis sicca -- CF
Zenker's diverticulum -- CF Upper GI diverticulum
Zollinger-Ellison syndrome -- CF Gastrin-secreting tumor associated with ulcers
Defic of CD55 and CD59, decay
accelerating factor (DAF) and
dx of Paroxysmal nocturnal hemoglobinuria (PNH)
membrane attack complex inhibiting
factor (MACIF)