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USMLE Step 1 > Classic Labs/Findings > Flashcards

Classic Labs/Findings Flashcards

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USMLE® Step 1 flashcards
1
Q

Anticentromere antibodies

A

Scleroderma (CREST)

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2
Q

Anti-desmoglein (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 snydrome (MPO-ANCA/p-ANCA); granulomatosis with polyangiitis (Wegner; PR3-ANCA/c-ANCA)

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8
Q

Antinuclear antibodies (ANA: 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-positive granular inclusions in granulocytes and myeloblasts

A

Auer rods (AML, especially promyelocytic M3 type, treat with all trans retinoic acid)

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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 xray

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

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 suppress sympathetic ganglion and cause Horner syndrome)

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22
Q

“Brown” tumor of bone

A

HyperPTH 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 crescents 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

Decreased 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 syphilis), 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: rigidity, 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

Disarraged 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 eyes)

A

Reed-Sternberg cells (Hodgkin lymphoma)

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42
Q

Glomerulus-like structure surrounding vessel in germ cells

A

Schiller-Duval bodies (yolk-sac tumor)

43
Q

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

A

B-thalassemia, sickle cell anemia (marrow expansion due to increased hematopoesis)

44
Q

hCG elevated

A

Choriocarcinoma, hydatidiform mole (occrs with and w/out 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, PE, DIC

49
Q

Hilar LAD, peripheral granulomatous lesion in middle or lower lung lobes (can calcify)

A

Ghon complex (primary TB: Mycobacterium bacilli)

50
Q

“Honey comb lumg” on xray or CT

A

Interstitial pulmonary fibrosis

51
Q

Hypercoagulability (leading to migrating DVTs and vasculitis)

A

Trousseau syndrome (adenocarcinoma of pancreas 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 (hyper-aldosteronism)

54
Q

Increased uric acid levels

A

Gout, lesch-nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics

55
Q

Intranuclear eosinophilic droplet-like bodies

A

Cowdry type A bodies (HSV or CMV)

56
Q

Iron-containing nodules in alveolar septum

A

Ferruginous bodies (asbestosis: increased chance of mesothelioma)

57
Q

Keratin pearls on a skin biopsy

A

Squamous cell carcinoma

58
Q

Large lysosomal vesicles in phagocytes, immunodeficiency

A

Chediak-Higashi disease (congenital failure of phagolysosome formation)

59
Q

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

A

Ulcerative colitis (loss of haustra)

60
Q

Linear appearance of IgG deposition on glomerular basement membrane

A

Goodpasture syndrome

61
Q

Low serum ceruloplasmin

A

Wilson disease (hepatolenticular degeneration)

62
Q

“Lumpy bumpy” appearance of glomeruli on immunofluorescence

A

Post-streptococcal glomerulonephritis (immune complex deposition of IgG and C3b)

63
Q

Lytic (hole punched) bone lesions on x-ray

A

Multiple myeloma

64
Q

Mammary gland (“blue domed”) cyst

A

Fibrocystic change of the breast

65
Q

Monoclonal antibody spike

A

Multiple myeloma (IgG or IgA); MGUS (aging); Waldenstrom (M protein = IgM); Primary amyloidosis

66
Q

Mucin-filled cell with peripheral nucleus

A

“signet ring” (gastric carcinoma)

67
Q

Narrowing of bowel lumen on barium x-ray

A

“String sign” (Crohn disease)

68
Q

Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis

A

Granulomatosis w/ polyangiitis (Wegener; PR3-ANCA/c-ANCA) and Goodpasture syndrome (anti-basement membrane antibodies)

69
Q

Needle-shaped, negatively birefringent crystals

A

Gout (monosodium urate crystals)

70
Q

Nodular hyaline deposits in glomeruli

A

Kimmelstiel-Wilson nodule (diabetic neuropathy)

71
Q

Novobiocin response

A

Sensitive: Staphylococcus epidermidis; resistant: Staphylococcus saprophyticus

72
Q

“Nutmeg” appearance of liver

A

Chronic passive congestion of liver due to right heart failure

73
Q

“Onion skin” periosteal reaction

A

Ewing sarcoma (malignant round-cell tumor)

74
Q

Optochin response

A

Sensitive: streptococcus pneumoniae; resistant: viridans streptococci

75
Q

Periosteum raised from bone, creating triangular area

A

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

76
Q

Podocyte fusion or “effacement” on electron microscope

A

Minimal change disease (child with nephrotic syndrome)

77
Q

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

A

Eburnation (osteoarthritis resulting in bony sclerosis)

78
Q

Protein aggregates in neurons from hyperphosphorylation of tau protein

A

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

79
Q

Psammoma bodies

A

Papillary thyroid carcinoma, serous carcinoma of the endometrium and ovary, mesothelioma, meningiomas

80
Q

Pseudopalisading tumor cells on brain biopsy

A

Glioblastoma multiforme

81
Q

RBC casts in urine

A

Acute glomerulonephritis

82
Q

Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells

A

Reinke crystals (Leydig cell tumor)

83
Q

Renal epithelial casts in urine

A

Acute toxic/viral renal injury

84
Q

Rhomboid crystals, positively birefringement

A

Pseudogout (CPPD crystals)

85
Q

Rib notching

A

coarctation of the aorta

86
Q

Ring-enhancing brain lesions in AIDS

A

Toxoplasma gondii, CNS lymphoma

87
Q

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

A

Burkitt lymphoma ([t8:14] c-myc activation, associated with EBV; “black-sky” made up of malignant cells)

88
Q

Silver-staining spherical aggregation of tau proteins in neurons

A

Pick bodies (Pick disease: progressive dementia, changes in personality)

89
Q

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

A

Giant cell-tumor of bone (generally benign)

90
Q

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

A

Membranous glomerulonephritis (may progress to nephrotic syndrome)

91
Q

Stacks of RBCs

A

Rouleaux formation (high ESR, multiple myeloma)

92
Q

Stippled vaginal epithelial cells

A

“Clue cells” (Gardnerella vaginalis)

93
Q

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

A

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

94
Q

Thrombi made of white/red layers

A

Lines of Zahn (arterial thrombus, layers of platelets/RBCs), pre-mortem clot

95
Q

“Thumb sign” on lateral x-ray

A

Epiglottitis (Haemophilus influenza)

96
Q

Thyroid-like appearance of kidney

A

Chronic bacterial pyelonephritis

97
Q

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

A

Membranoproliferative glomerulonephritis

98
Q

Triglyceride accumulation in liver cell vacuoles

A

Fatty liver disease (alcoholic or metabolic syndrome)

99
Q

“Waxy” casts with very low urine flow

A

Chronic end-stage renal disease

100
Q

WBC casts in urine

A

Acute pyelonephritis

101
Q

WBCs that look smudged

A

CLL (almost always B-cell)

102
Q

“Wire loop” glomerular capillary appearance on light microscopy

A

Lupus nephropathy

103
Q

Yellowish CSF

A

Xanthochromia (eg due to subarachnoid hemorrhage)

USMLE Step 1 (36 decks)

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