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GENERAL USMLE > classic lab findings > Flashcards

classic lab findings Flashcards

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USMLE® Step 1 flashcards
1
Q

Anticentromere 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’s syndrome (glomerulonephritis and lung hemorrhage)

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4
Q

Antihistone antibodies

A

Drug-induced SLE

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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

Vasculitis (Wegener’s, microscopic polyangiitis, glomerulonephritis)

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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 (ITP) (bleeding diathesis)

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10
Q

Anti-topoisomerase antibodies

A

Diffuse systemic scleroderma

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11
Q

Anti-transglutaminase/antigliadin antibodies

A

Celiac disease (diarrhea, distention, weight loss)

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12
Q

Azurophilic granular needles in leukemic blasts

A

Auer rods (acute myelogenous leukemia: especially the promyelocytic type)

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13
Q

“Bamboo spine” on x-ray

A

Ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27)

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14
Q

Basophilic nuclear remnants in RBCs

A

Howell-Jolly bodies (due to splenectomy or nonfunctional spleen)

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15
Q

Basophilic stippling of RBCs

A

Lead poisoning or sideroblastic anemia

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16
Q

Bloody tap on LP

A

Subarachnoid hemorrhage

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17
Q

“Boot-shaped” heart on x-ray

A

Tetralogy of Fallot, RVH

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18
Q

Branching gram-positive rods with sulfur granules

A

Actinomyces israelii

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19
Q

Bronchogenic apical lung tumor

A

Pancoast’s tumor (can compress sympathetic ganglion and cause Horner’s syndrome)

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20
Q

“Brown” tumor of bone

A

Hemorrhage (hemosiderin) causes brown color of osteolytic cysts. Due to 1. Hyperparathyroidism, 2. Osteitis fibrosa cystica

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21
Q

Cardiomegaly with apical atrophy

A

Chagas’ disease (Trypanosoma cruzi )

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22
Q

Cellular crescents in Bowman’s capsule

A

Rapidly progressive crescentic glomerulonephritis

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23
Q

“Chocolate cyst” of ovary

A

Endometriosis (frequently involves both ovaries)

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24
Q

Circular grouping of dark tumor cells surrounding pale neurofibrils

A

Homer Wright rosettes (neuroblastoma, medulloblastoma, retinoblastoma)

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25
Q

Colonies of mucoid Pseudomonas in lungs

A

Cystic fibrosis (CFTR mutation in Caucasians resulting in fat-soluble vitamin deficiency and mucous plugs)

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26
Q

Degeneration of dorsal column nerves

A

Tabes dorsalis (Tertiary syphilis)

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27
Q

Depigmentation of neurons in substantia nigra

A

Parkinson’s disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia)

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28
Q

Desquamated epithelium casts in sputum

A

Curschmann’s spirals (bronchial asthma; can result in whorled mucous plugs)

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29
Q

Disarrayed granulosa cells in eosinophilic fluid

A

Call-Exner bodies (granulosa-theca cell tumor of the ovary)

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30
Q

Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia

A

Koilocytes (HPV: predisposes to cervical cancer)

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31
Q

Enlarged cells with intranuclear inclusion bodies

A

“Owl’s-eye” appearance of CMV

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32
Q

Enlarged thyroid cells with ground-glass nuclei

A

“Orphan Annie” eye nuclei (papillary carcinoma of the thyroid)

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33
Q

Eosinophilic cytoplasmic inclusion in liver cell

A

Mallory bodies (alcoholic liver disease)

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34
Q

Eosinophilic cytoplasmic inclusion in nerve cell

A

Lewy body (Parkinson’s disease)

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35
Q

Eosinophilic globule in liver

A

Councilman body (toxic or viral hepatitis, often yellow fever)

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36
Q

Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells

A

Rabies virus (Lyssavirus)

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37
Q

Extracellular amyloid deposition in gray matter of brain

A

Senile plaques (Alzheimer’s disease)

38
Q

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

A

Reed-Sternberg cells (Hodgkin’s lymphoma)

39
Q

Glomerulus-like structure surrounding vessel in germ cells

A

Schiller-Duval bodies (yolk sac tumor)

40
Q

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

A

_-thalassemia, sickle cell anemia (extramedullary hematopoiesis)

41
Q

hCG elevated

A

Choriocarcinoma, hydatidiform mole (occurs with and without embryo)

42
Q

Heart nodules (inflammatory)

A

Aschoff bodies (rheumatic fever)

43
Q

Heterophile antibodies

A

Infectious mononucleosis (EBV)

44
Q

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

A

Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)

45
Q

High level of D-dimers

A

DVT, pulmonary embolism, DIC

46
Q

“Honeycomb lung” on x-ray

A

Interstitial fibrosis

47
Q

Hypersegmented neutrophils

A

Megaloblastic anemia (B12, folate deficiency)

48
Q

Hypochromic, microcytic anemia

A

Iron deficiency anemia, lead poisoning, thalassemia (HbF sometimes present)

49
Q

Increased _-fetoprotein in amniotic fluid/ maternal serum

A

Anencephaly, spina bifida (neural tube defects)

50
Q

Increased uric acid levels

A

Gout, Lesch-Nyhan syndrome, myeloproliferative disorders, loop and thiazide diuretics

51
Q

Intranuclear eosinophilic droplet-like bodies

A

Cowdry type A bodies (HSV or yellow fever)

52
Q

Iron-containing nodules in alveolar septum

A

Ferruginous bodies (asbestosis: _ chance of mesothelioma)

53
Q

Large lysosomal vesicles in phagocytes, immunocompromised

A

Chediak-Higashi disease (failure of phagolysosome formation)

54
Q

Low serum ceruloplasmin

A

Wilson’s disease (hepatolenticular degeneration)

55
Q

“Lumpy-bumpy” appearance of glomeruli on immunofluorescence

A

Poststreptococcal glomerulonephritis

56
Q

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

A

Multiple myeloma

57
Q

Mammary gland (“blue-domed”) cyst

A

Fibrocystic change of the breast

58
Q

Monoclonal antibody spike (4) indications)

A
  1. Multiple myeloma (called the M protein; usually IgG or IgA), 2. Monoclonal gammopahy of undetermined significance (MGUS; normal consequence of aging), 3. Waldenstrom’s (M protein = IgM) macroglobulinemia, 4. Primary amyloidosis
59
Q

Monoclonal globulin protein in blood/urine

A

Bence Jones proteins (multiple myeloma [kappa or lambda Ig light chains in urine]), Waldenstrom’s macroglobulinemia (IgM)

60
Q

Mucin-filled cell with peripheral nucleus

A

Signet ring (gastric carcinoma)

61
Q

Narrowing of bowel lumen on barium radiograph

A

“String sign” (Crohn’s disease)

62
Q

Needle-shaped, negatively birefringent crystals

A

Gout (hyperuricemia)

63
Q

Nodular hyaline deposits in glomeruli

A

Kimmelstiel-Wilson nodules (diabetic nephropathy)

64
Q

“Nutmeg” appearance of liver

A

Chronic passive congestion of liver due to right heart failure

65
Q

“Onion-skin” periosteal reaction

A

Ewing’s sarcoma (malignant round-cell tumor)

66
Q

Periosteum raised from bone, creating triangular area

A

Codman’s triangle on x-ray (osteosarcoma, Ewing’s sarcoma, pyogenic osteomyelitis)

67
Q

Podocyte fusion on EM

A

Minimal change disease (child with nephrotic syndrome)

68
Q

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

A

Eburnation (osteoarthritis resulting in bony sclerosis)

69
Q

Protein aggregates in neurons from hyperphosphorylation of protein tau

A

Neurofibrillary tangles (Alzheimer’s disease and CJD)

70
Q

Pseudopalisade tumor cell arrangement

A

Glioblastoma multiforme

71
Q

RBC casts in urine

A

Acute glomerulonephritis

72
Q

Rectangular, crystal-like inclusions in Leydig cells

A

Reinke crystals (Leydig cell tumor)

73
Q

Renal epithelial casts in urine

A

Acute toxic/viral nephrosis

74
Q

Rhomboid crystals, positively birefringent

A

Pseudogout (calcium pyrophosphate dihydrate)

75
Q

Rib notching

A

Coarctation of the aorta

76
Q

Sheets of medium-sized lymphoid cells (“starry sky” appearance on histology)

A

Burkitt’s lymphoma (t[8:14] c-myc activation, associated with EBV)

77
Q

Silver-staining spherical aggregation of tau proteins in neurons

A

Pick bodies (Pick’s disease: progressive dementia, similar to Alzheimer’s)

78
Q

Small granulomatous lesion in lungs (can calcify)

A

Ghon focus (Primary TB: Mycobacterium bacilli)

79
Q

Small, round RBC inclusions

A

Heinz bodies (G6PD deficiency, _-thalassemia, chronic liver disease)

80
Q

“Soap bubble” on x-ray

A

Giant cell tumor of bone (generally benign)

81
Q

“Spikes” on basement membrane, “dome-like” endothelial deposits

A

Membranous glomerulonephritis (may progress to nephrotic syndrome)

82
Q

Stacks of red blood cells

A

Rouleaux formation (high ESR: multiple myeloma)

83
Q

Stippled vaginal epithelial cells

A

“Clue cells” (Gardnerella vaginalis)

84
Q

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

A

Birbeck granules (histiocytosis X: eosinophilic granuloma)

85
Q

Thrombi made of white/red layers

A

Lines of Zahn (arterial thrombus, layers of platelets/RBCs)

86
Q

“Thumb sign” on lateral x-ray

A

Epiglottitis (Haemophilus influenzae)

87
Q

Thyroid-like appearance of kidney

A

Chronic bacterial pyelonephritis

88
Q

“Tram-track” appearance on LM

A

Membranoproliferative glomerulonephritis

89
Q

Triglyceride accumulation in liver cell vacuoles

A

Fatty liver disease (alcoholic or metabolic syndrome)

90
Q

WBCs that look “smudged”

A

CLL (almost always B cell; affects the elderly)

91
Q

“Wire loop” glomerular appearance on LM

A

Lupus nephropathy

92
Q

Yellow CSF

A

Xanthochromia (subarachnoid hemorrhage)

GENERAL USMLE (5 decks)

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