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High yield step 1 > Classic Labs- Diagnosis > Flashcards

Classic Labs- Diagnosis 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 syndrome (glomerulonephritis and hemoptysis)

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4
Q

Antihistone antibodies

A

Drug-induced SLE (hydralazine, INH, phenytoin, procainaminde)

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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

Antineutrophile cytoplasmic antibodies (ANCAs)

A

Microscopic polyangiitis and Churg-Strauss syndrome (MPO-ANCA/p-ANCA); granulomatosis with polyangiitis (Wegner; 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, distention,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 granulocytes and myeloblasts

A

Auer rods (AML, especially the promyelocytic [M3] type)

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14
Q

Bacitracin response

A

Sensitive: Strep pyogenes (group A); Resistant: Strep agalactiae (group B)

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15
Q

“bambo 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 strippling of RBC’s

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

Tetralogy of Fallot, RVH

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20
Q

Branching gram-positive rods with sulfur granules

A

Actinomyces israelii

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21
Q

Bronchogenic apical lung tumor on imaging

A

Pancoast tumor ( can compress smpathetic 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 with apical atrophy

A

Chagas disease( Trypanosoma cruzi)

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24
Q

Cellular crescent 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 reintoblastoma)

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27
Q

Colonies of mucoid Pseudomonas in lungs

A

Cystic fibrosis ( autosomal recessive mutation in CFTR gene leads to fat-soluble vitamin deficiency and mucous plugs)

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28
Q

decreased AFP in amniotic fluid/maternal serum

A

Down syndrome or other chromosomal abnormailty

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29
Q

Degeneration of dorsal column nerves

A

Tabes dorsalis ( 3 syphilis), subacute combined degeneration( dorasl columns and lateral corticospinal tracts affected)

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30
Q

Depigmentation of neurons in substantia nigra

A

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

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31
Q

Desquamated epithelium cast 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

Enlarge cells with intranuclear inclusion bodies

A

“Owl eye” appearance of CMV

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35
Q

Enlarged thyroid cells with ground class nuclei

A

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

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36
Q

Eosinophilic cytoplasmic inclusion in liver cells

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 of germ cells

A

Schiller-Duval bodies (yolk sac tumor)

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43
Q

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

A

B-thalassemia, sickle cell anemia (marrow expansion)

44
Q

hCG elevated

A

Choriocarcinoma, hydatidiform mole(occurs with and without 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 crystal in bronchial secretions

A

Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)

48
Q

High level of D-dimers

A

DVT, PE, DIC

49
Q

Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes

A

Ghon complex ( 1 TB: Mycobacterium bacilli)

50
Q

“honeycomb lung” on x-ray or CT

A

Interstitial pulmonary fibrosis

51
Q

Hypercoagulability ( leading to migrating DVT’s and vasculitis)

A

Trousseau syndrome ( adenocarcinoma of pancrease or lung)

52
Q

hypersegmented neutrophils

A

Megaloblastic anemia (B12 deficiency: neurologic symptoms: folate deficiency: no neurologic symptoms)

53
Q

Hypertension, hypokalemia, metabolic alkalosis

A

Conn syndrome

54
Q

Hypochromic, microcytic anemia

A

Iron deficiency anemia, lead poisoning, thalassemia

55
Q

Increased AFP in amniotic fluid/maternal serum

A

Dating error, anencephaly, spina bifida (neural tube defects)

56
Q

Increased uric acid levels

A

Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diurectics

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 (asbesosis: 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 phagolysome 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 syndrome

63
Q

Low serum ceruloplasmin

A

Wilson disease ( hepatolenticular degeneration)

64
Q

“lumpy bumpy appearance of glomeruli on immunofluorescence

A

Poststreptococcal glomerulonphritis ( 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 the breast

67
Q

Monoclonal antibody spike

A
  • multiple myeloma ( usually IgG or IgA)
  • Monoclonal gammopathy of undetermined significance ( MGUS consequence of again)
  • waldenstrom ( M protein = IgM) macroglobulinemia
  • Primary amyloidosis
68
Q

Mucin-filled cell with peripheral nucleus

A

“signet ring” (gastric carcinoma)

69
Q

Narrowing of bowel lumen on barium x-ray

A

“string sign” (crohn disease)

70
Q

Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis

A

Granulomatosis with polyangiitis ( Wegener; PR3-ANCA/c-ANCA) and Goodpasture 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: Staph epidermidis
Resistant: Staph saprophyticus

74
Q

“nutmeg” appearance of liver

A

Chronic passive congestion of liver due to right heart failure

75
Q

“onion skin” periosteal reaction

A

Ewing saarcoma (malignant round-cell tumor)

76
Q

Optochin response

A

Sensitive: Strep pneumoniae
Resistant: Viridans strep

77
Q

Periosteum raised form bone, creating triangular area

A

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

78
Q

Podocyte fusion or “effacement” on electron microscopy

A

Minimal change disease (child with nephrotic syndrome)

79
Q

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

A

Eburnation (osteoarthritis resulting in bony sclerosis)

80
Q

Protein aggregates in neurons from hyperphosphorylation of tau protein

A

Neurofibrillary tangles ( Alzheimer disease) and Pick bodies ( Pick disease)

81
Q

psammoma bodies

A

Meningiomas, papillary thyroid carcinoma, mesothelimoa, papillary serous carcinoma of the 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 renal injury

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 lesion in AIDS

A

Toxoplasma gondii, CNA lymphoma

89
Q

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

A

Burkitt lymphoma (t 8:14) c-myc activation, assoiated with EBV; “black sky” made up of maligant cells”/)

90
Q

Silver-staining spherical aggregation of tau proteins in neurons

A

Pick bodies ( Pick 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 basemnt membrane, “dome-like” subepithelial deposits

A

membranous glomerulonephritis ( may progress to nephrotic syndrome)

93
Q

Stacks of RBC’s

A

Rouleaux formation ( high ESR, multople myeloma)

94
Q

Strippled vaginal epithelial cells

A

“Clue cells” (gardneralla baginalis)

95
Q

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

A

Birbeck granules ( Langerhans cell histiocytosis or histiocytosis X: eosinophilic 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

Epiglottitis ( 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

Membranoproliferatice glomerulonephritis

100
Q

Triglyceride accumulation in lever 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 urnine

A

Acute pyelonephritis

103
Q

WBC’s that looked “smudge”

A

CLL ( almost always B cell)

104
Q

“wire loop” glomerular capillary appearance on light microscopy

A

lupus nephropathy

105
Q

Yellowish CSF

A

Xanthochromia ( eg, due to subarachnoid hemorrhage)

High yield step 1 (8 decks)

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