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USMLE Step 1 > Classic Lab/Diagnostic Findings (First Aid Rapid Review) > Flashcards

Classic Lab/Diagnostic Findings (First Aid Rapid Review) Flashcards

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USMLE® Step 1 flashcards
1
Q

Anti-centromere antibodies

A

Scleroderma

CREST

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2
Q

Antidesmoglein (epithelial) antibodies

A

Pemphigus vulgaris

Blistering

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3
Q

Anti-glomerular basement membrane antibodies

A

Goodpasture syndrome

Glomerulonephritis and hemoptysis

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4
Q

Antihistone antibodies

A

Drug-induced SLE

Hydralazine, INH, Phenytoin, Procainamide

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5
Q

Anti-IgG antibodies

A 
Rheumatoid arthritis
(Systemic inflammation, joint pannus, boutonniere deformity)
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6
Q

Antimitochondrial antibodies (AMAs)

A

Primary biliary cirrhosis

Female, cholestasis, portal hypertension

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7
Q

Antineutrophil cytoplasmic antibodies (ANCAs)

A

Microscopic polyangiitis and Churg-Strauss syndrome (MPO-ANCA/p-ANCA)

Granulomatosis w/ polyangiitis (Wegener; PR3-ANCA/c-ANCA)

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8
Q

Antinuclear antibodies (ANAs: anti-Smith and anti-dsDNA)

A

SLE

Type III hypersensitivity

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9
Q

Antiplatelet antibodies

A

Idiopathic thrombocytopenic purpura

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10
Q

Anti-topoisomerase antibodies

A

Diffuse systemic scleroderma

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11
Q

Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies

A

Celiac disease

Diarrhea, distension, weight loss

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12
Q

“Apple core” lesion on abdominal x-ray

A

Colorectal cancer

Usually left-sided

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13
Q 
Azurophilic peroxidase (+)
Granular inclusions in granulocyte and myeloblasts
A 
Auer rods
(AML, especially the promyelocytic [M3] type)
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14
Q

Bacitracin response

A

Sensitive: Streptococcus pyogenes (Group A)
Resistant: Streptococcus agalactiae (Group B)

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15
Q

“Bamboo spine” on x-ray

A

Ankylosing spondylitis

Chronic inflammatory arthritis: HLA-B27

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16
Q

Basophilic nuclear remnants in RBCs

A

Howell-Jolly bodies

Due to splenectomy or nonfunctional spleen

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17
Q

Basophilic stippling of RBCs

A

Lead poisoning or sideroblastic anemia

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18
Q

Bloody tap on LP

A

Subarachnoid hemorrhage

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19
Q

“Boot-shaped” heart on x-ray

A

Tetrology of Fallot

RVH

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20
Q

Branching gram+ rods w/ sulfur granules

A

Actinomyces israelii

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21
Q

Bronchogenic apical lung tumor on imaging

A

Pancost tumor

Can compress sympathetic ganglion and cause Horner syndrome

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22
Q

“Brown” tumor of bone

A

Hyperparathyroidism
or
Osteitis fibrosa cystica
(deposited hemosiderin from hemorrhage gives brown color)

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23
Q

Cardiomegaly w/ apical atrophy

A

Chagas disease

Trypanosoma cruzi

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24
Q

Cellular cresents in Bowman capsule

A

Rapidly progressive crescentic glomerulonephritis

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25
Q

“Chocolate cyst” of ovary

A

Endometriosis

Frequently involves both ovaries

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26
Q

Circular grouping of dark tumor cells surrounding pale neurofibrils

A

Homer-Wright rosettes

Neuroblastoma, medulloblastoma, retinoblastoma

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27
Q

Colonies of mucoid Pseudomonas in lungs

A 
Cystic fibrosis
(Autosomal recessive mutation in CFTR gene --> fat soluble vitamin deficiency and mucous plugs)
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28
Q

Decrease AFP in amniotic fluid/maternal serum

A

Down syndrome
or
Other chromosomal abnormality

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29
Q

Degeneration of dorsal column nerves

A 
Tabes dorsalis (Tertiary syphillis)
Subacute combined degeneration (Dorsal columns and lateral corticospinal tracts affected)
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30
Q

Depigmentation of neurons in substantia nigra

A

Parkinson disease

Basal ganglia disorder: ridgidity, resting tremor, bradykinesia

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31
Q

Desquamated epithelium casts in sputum

A

Curschmann spirals
(Bronchial asthma)
(Can result in whorled mucous plugs)

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32
Q

Disarrayed granulosa cells in eosinophilic fluid

A

Call-Exner bodies

Granulosa-theca cell tumor of the ovary

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33
Q

Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia

A

Koilocytes

HPV: predisposes to cervical cancer

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34
Q

Enlarged cells with intranuclear inclusion bodies

A

“Owl eye” appearance of CMV

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35
Q

Enlarged thyroid cells with ground-glass nuclei

A

“Orphan Annie” eyes nuclei

Papillary carcinoma of the thyroid

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36
Q

Eosinophilic cytoplasmic inclusion in liver cell

A

Mallory body

Alcoholic liver disease

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37
Q

Eosinophilic cytoplasmic inclusion in nerve cell

A

Lewy body

Parkinson disease

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38
Q

Eosinophilic globule in liver

A

Councilman body

Toxic or viral hepatitis, often yellow fever

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39
Q

Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar nerve cells

A

Negri bodies of rabies

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40
Q

Extracellular amyloid deposition in gray matter of brain

A

Senile plaques

Alzheimer disease

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41
Q

Giant B cells with bilobed nuclei with prominent inclusions (“owl’s eye”)

A

Reed-Sternberg cells

Hodgkin lymphoma

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42
Q

Glomerulus-like structure surrounding vessel in germ cell

A

Schiller-Duval bodies

Yolk sac tumor

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43
Q

“Hair on end” (crew-cut) appearance on x-ray

A

B-thalassemia
Sickle cell anemia
(Marrow expansion)

44
Q

hCG elevated

A

Choriocarcinoma
Hydatiform mole
(occurs w/ and w/o embryo, and multiple pregnancy)

45
Q

Heart nodules (granulomatous)

A

Aschoff bodies

rheumatic fever

46
Q

Heterophile antibodies

A

Infectious mononucleosis

EBV

47
Q

Hexagonal, double-pointed, needle-like crystals in bronchial secretions

A

Bronchial asthma

Charcot-Leyden crystals: eosinophilic granules

48
Q

High level of D-dimers

A

DVT
Pulmonary embolism
DIC

49
Q

Hilar LAD

Peripheral granulomatous lesions in middle or lower lung lobes (can calcify)

A

Ghon complex

Primary TB: Mycobacterium bacilli

50
Q

“Honeycomb lung” on x-ray or CT

A

Interstitial pulmonary fibrosis

51
Q

Hypercoagulability (leading to migrating DVTs and vasculitis)

A

Trousseau’s syndrome

Adenocarcinoma of pancreas or lungs

52
Q

Hypersegmented neutrophils

A 
Megaloblastic anemia
(B12 deficiency: neurologic sx)
(Folate deficiency: no neurologic sx)
53
Q

HTN
HYPOkalemia
Metabolic ALKalosis

A

Conn’s syndrome

54
Q

Hypochromic, microcytic anemia

A

Iron deficiency anemia
Lead poisoning
Thalassemia (fetal Hb sometimes present)

55
Q

Increased alpha-fetoprotein in amniotic fluid/maternal serum

A

Dating error
Anencephaly
Spina bifida (NT defects)

56
Q

Increased uric acid levels

A

Gout
Lesch-Nyhan syndrome
Tumor lysis syndrome
Loop and thiazide diuretics

57
Q

Intranuclear eosinophilic droplet-like bodies

A

Cowdry type A bodies

HSV or CMV

58
Q

Iron-containing nodules in alveolar septum

A 
Ferruginous bodies
(Asbestosis: increased chance of mesothelioma)
59
Q

Keratin pearls on a skin biopsy

A

Squamous cell carcinoma

60
Q

Large lysosomal vesicles in phagocytes

Immunodeficiency

A

Chediak-Higashi disease

Congenital failure of phagolysosome formation

61
Q

“Lead pipe” appearance of colon on barium enema x-ray

A

Ulcerative colitis

Loss of haustra

62
Q

Linear appearance of IgG deposition on glomerular basement membrane

A

Goodpasture’s syndrome

63
Q

Low serum ceruloplasmin

A

Wilson’s disease

Hepatolenticular degeneration

64
Q

“Lumpy bumpy” appearance of glomeruli on immunofluorescence

A

Post-streptococcal glomerulonephritis

Immune complex deposition of IgG and C3b

65
Q

Lytic (“hole punched”) bone lesions on x-ray

A

Multiple myeloma

66
Q

Mammary gland (“blue domed”) cyst

A

Fibrocystic change of breast

67
Q

Monoclonal antibody spike

A 
Multiple myeloma (usually IgG or IgA)
Monoclonal gammopathy of undetermined significance (MGUS; normal consequence of aging)
Waldenstrom's (M protein=IgM) macroglobulinemia
Primary amyloidosis
68
Q

Mucin-filled cell w/ peripheral nucleus

A

Signet ring

Gastric carcinoma

69
Q

Narrowing of bowel lumen on barium x-ray

A

“String sign”

Crohn’s disease

70
Q

Necrotizing vasculitis (lungs)
and
Necrotizing glomerulonephritis

A

Granulomatosis w/ polyangiitis (Wegener’s; (+) c-ANCA)

Goodpasture’s syndrome (anti-basement membrane antibodies)

71
Q

Needle-shaped

Negatively birefringent crystals

A

Gout

Monosodium urate crystals

72
Q

Nodular hyaline deposits in glomeruli

A

Kimmelstiel-Wilson nodules

Diabetic nephropathy

73
Q

Novobiocin response

A

Sensitive: Staphlococcus epidermidis
Resistant: Staphlococcus saprophyticus

74
Q

“Nutmeg” appearance of liver

A

Chronic passive congestion of liver due to RH failure

75
Q

“Onion skin” periosteal reaction

A

Ewing’s sarcoma

Malignant round-cell tumor

76
Q

Optochin response

A

Sensitive: Streptococcus pneumoniae
Resistant: Viridans streptococcus

77
Q

Periosteum raised from bone, creating triangular area

A

Codman’s triangle on x-ray

Osteosarcoma, Ewing’s sarcoma, pyogenic osteomyelitis

78
Q

Podocyte fusion or “effacement” on electron microscopy

A

Minimal change disease

Child w/ nephrotic syndrome

79
Q

Polished, “ivory like” appearance of bone at cartilage erosion

A

Eburnation

Osteoarthritis resulting in bone sclerosis

80
Q

Protein aggregates in neurons from hyperphosphorylation of protein tau

A 
Neurofibrillary tangles (Alzheimer's disease)
Pick's bodies (Pick's disease)
81
Q

Psammoma bodies

A

Meningiomas
Papillary thyroid carcinoma
Mesothelioma
Papillary serous carcinoma of endometrium and ovary

82
Q

Pseudopalisading tumor cells on brain biopsy

A

Glioblastoma multiforme

83
Q

RBC casts in urine

A

Acute glomerulonephritis

84
Q

Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells

A

Reinke crystals

Leydig cell tumor

85
Q

Renal epithelial casts in urine

A

Acute toxic/viral nephrosis

86
Q

Rhomboid crystals

Positively birefringent

A

Pseudogout

Calcium pyrophosphate dihydrate crystals

87
Q

Rib notching

A

Coarctation of the aorta

88
Q

Ring-enhancing brain lesions in AIDS

A

Toxoplasma gondii

CNS lymphoma

89
Q

Sheets of medium-sized lymphoid cells with scattered pale, tingible body-laden macrophages
(“Starry sky” histology)

A

Burkitt’s lymphoma

t[8:14] c-myc activation, associated with EBV; “black sky” made up of malignant cells

90
Q

Silver-staining spherical aggregation of tau proteins in neurons

A 
Pick bodies
(Pick's disease: progressive dementia, changes in personality)
91
Q

“Soap bubble” in femur or tibia on x-ray

A

Giant cell tumor of bone

Generally benign

92
Q

“Spikes” on basement membrane

“Dome like” subepithelial deposits

A

Membranous glomerulonephritis

May progress to nephrotic syndrome

93
Q

Stacks of RBCs

A

Rouleaux formation

High ESR, multiple myeloma

94
Q

Stippled vaginal epithelial cells

A

“Clue cells”

Gardnerella vaginalis

95
Q

“Tennis racket” shaped cytoplasmic organelles (EM) in Langerhans cells

A

Birbeck granules
(Langerhans cell histiocytosis
or histiocytosis X: eosinophlic granuloma)

96
Q

Thrombi made of white/red layers

A

Lines of Zahn

Arterial thrombus, layers of platelets/RBCs

97
Q

“Thumb sign” on lateral x-ray

A

Epiglotittis

Haemophilus influenzae

98
Q

Thyroid-like appearance of kidney

A

Chronic bacterial pyelonephritis

99
Q

Tram-track appearance of capillary loops of glomerular basement membranes on light microscopy

A

Membranoproliferative glomerulonephritis

100
Q

Triglyceride accumulation in liver cell vacuoles

A

Fatty liver disease

Alcoholic or metabolic syndrome

101
Q

“Waxy” casts with very low urine flow

A

Chronic end-stage renal disease

102
Q

WBC casts in urine

A

Acute pyelonephritis

103
Q

WBCs that look “smudged”

A

CLL

Almost always B cell

104
Q

“Wire loop” glomerular capillary appearance on light microscopy

A

Lupus nephritis

105
Q

Yellowish CSF

A

Xanthochromia

e.g. due to subarachnoid hemorrhage

USMLE Step 1 (4 decks)

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