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USMLE Rapid Review > Classic Labs/Findings > Flashcards

Classic Labs/Findings Flashcards

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USMLE® Step 1 flashcards
0
Q

Pemphigus vulgaris

A

Antidesmoglein (epithelial) antibodies [blistering]

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1
Q

Scleroderma (CREST)

A

Anticentromere antibodies (CREST syndrome = limited/cutaneous scleroderma; CREST = calcinosis, Raynaud’s phenomenon, esophageal dysmotility, sclerodactyly, telangiectasia)

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2
Q

Goodpasture’s syndrome

A

Anti-glomerular basement membrane antibodies (glomerulonephritis and hemoptysis)

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3
Q

Drug-induced SLE

A

Antihistone antibodies (hydralazine, isoniazid, phenytoin, procainamide; anti-HIPP-stone antibodies)

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4
Q

Rheumatoid arthritis

A

Anti-IgG antibodies (systemic inflammation, joint pannus, boutonnière deformity)

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5
Q

Primary biliary cirrhosis

A

Antimitochondrial antibodies (AMAs) [female, cholestasis, portal hypertension]

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6
Q

Vasculitis

A

Antineutrophil cytoplasmic antibodies (ANCAs) [c-ANCA: granulomatosis with polyangiitis, Wegener’s granulomatosis; p-ANCA: microscopic polyangiitis, Churg-Strauss syndrome)

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7
Q

SLE (systemic lupus erythematosus)

A

Antinuclear antibodies (ANAs: antiSmith and anti-dsDNA) [type III hypersensitivity)

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8
Q

Idiopathic thrombocytopenic purpura

A

Antiplatelet antibodies

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9
Q

Diffuse systemic scleroderma

A

Anti-topoisomerase antibodies = anti-scl70 antibodies

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10
Q

Celiac disease

A

Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies (diarrhea, distension, weight loss)

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11
Q

Colorectal cancer

A

“Apple core” lesion on abdominal x-ray (usually left sided)

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12
Q

Auer cross

A

Azurophilic peroxidase-positive granular inclusions in granulocytes and myeloblasts (acute myelogenous leukemia, especially the promyelocytic [M3] type)

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13
Q

Bacitracin response

A

Sensitive: Streptococcus pyogenes (group A); resistant: Streptococcus agalactiae (group B; group B Beats Bacitracin)

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14
Q

Akylosing spondylitis

A

“Bamboo spine” on x-ray (chronic inflammatory arthritis; strong association with HLA-B27)

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15
Q

Howell-Jolly bodies

A

Basophilic nuclear remnants in RBCs (due to splenectomy or nonfunctional spleen)

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16
Q

Lead poisoning or sideroblastic anemia

A

Basophilic stippling of RBCs

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17
Q

Subarachnoid hemorrhage

A

Bloody tap on LP

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18
Q

Tetralogy of Fallot, RVH

A

“Boot-shaped” heart on x-ray

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19
Q

Actinomyces israelii

A

Branching gram-positive rods with sulfur granules

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20
Q

Pancoast tumor

A

Bronchogenic apical lung tumor on imaging (can compress sympathetic ganglion and cause Horner’s syndrome)

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21
Q

Hyperparathyroidism or osteitis fibrosa cystica

A

“Brown” tumor of bone (deposited hemosiderin from hemorrhage gives brown color)

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22
Q

Chagas’ disease

A

Cardiomegaly with apical atrophy (Trypanosoma cruzi)

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23
Q

Rapidly progressive crescentic glomerulonephritis

A

Cellular crescents in Bowman’s capsule

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24
Q

Endometriosis

A

“Chocolate cyst” of ovary (frequently involves both ovaries)

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25
Q

Homer-Wrightt rosettes

A

Circular grouping of dark tumor cells surrounding pale neurofibrils (neuroblastoma, medulloblastoma, retinoblastoma)

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26
Q

Cystic fibrosis

A

Colonies of mucoid Pseudomonas in lungs (AR mutation in CFTR resulting in fat-soluble vitamin deficiency and mucous plugs)

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27
Q

Down syndrome or other chromosomal abnormality

A

⬇️ alpha-fetoprotein in amniotic fluid/maternal serum (in Down syndrome, alpha-fetoprotein goes DOWN; vs. neural tube defects, which have ⬆️ alpha-fetoprotein)

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28
Q

Tabes dorsalis, subacute combined degeneration

A

Degeneration of dorsal column nerves (tabes dorsalis: tertiary syphilis; in subacute combined degeneration, dorsal columns and lateral corticospinal tracts affected)

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29
Q

Parkinson’s disease

A

Depigmentation of neurons in substantia nigra (basal ganglia disorder: rigidity, resting tremor, bradykinesia)

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30
Q

Curschmann’s spirals

A

Desquamated epithelium casts in sputum (bronchial asthma; can result in whorled mucous plugs)

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31
Q

Call-Exner bodies

A

Disarrayed granulosa cells in eosinophilic fluid (granulosa-theca cell tumor of the ovary)

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32
Q

Koilocytes

A

Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia (HPV; predisposes to cervical cancer)

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33
Q

“Owl’s eye” appearance

A

Enlarged cells with intranuclear inclusion bodies (CMV)

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34
Q

“Orphan Annie’s eyes” nuclei

A

Enlarged thyroid cells with ground-glass nuclei (papillary carcinoma of the thyroid)

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35
Q

Mallory bodies

A

Eosinophilic cytoplasmic inclusion in liver cell (alcoholic liver disease)

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36
Q

Lewy body

A

Eosinophilic cytoplasmic inclusion in nerve cell (Parkinson’s disease)

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37
Q

Councilman body

A

Eosinophilic globule in liver (toxic or viral hepatitis, often yellow fever)

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38
Q

Negri bodies

A

Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells (rabies, Lyssavirus)

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39
Q

Senile plaques

A

Extracellular amyloid deposition in gray matter of brain (Alzheimer’s disease)

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40
Q

Reed-Sternberg cells

A

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

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41
Q

Schiller-Duval bodies

A

Glomerulus-like structure surrounding vessel in germ cells (yolk sac tumor)

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42
Q

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

A

Beta-thalassemia, sickle cell anemia (due to marrow expansion)

43
Q

⬆️ hCG

A

Choriocarcinoma, hydatidiform mole (occurs with and without embryo)

44
Q

Aschoff bodies

A

Heart nodules (granulomatous) [rheumatic fever]

45
Q

Infectious mononucleosis

A

Heterophile antibodies (EBV)

46
Q

Bronchial asthma

A

Charcot-Leyden crystals: eosinophilic granules (hexagonal, double-pointed, needle-like crystals in bronchial secretions)

47
Q

High level of D-dimers

A

DVT, pulmonary embolism, DIC

48
Q

Ghon complex

A

Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify) [primary TB: Mycobacterium bacilli]

49
Q

Interstitial pulmonary fibrosis

A

“Honeycomb lung” on x-ray or CT

50
Q

Trousseau’s syndrome

A

Hypercoagulability (leading to migrating DVTs and vasculitis) [adenocarcinoma of pancreas or lung]

51
Q

Megaloblastic anemia

A

Hypersegmented neutrophils (B12 deficiency: neurologic symptoms; folate deficiency: no neurologic symptoms)

52
Q

Conn’s syndrome

A

Hypertension, hypokalemia, metabolic alkalosis (primary hyperaldosteronism, specifically an aldosterone-secreting adrenal adenoma)

53
Q

Hypochromic, microcytic anemia

A

Iron deficiency anemia, lead poisoning, thalassemia (fetal Hb sometimes present)

54
Q

⬆️ alpha-fetoprotein in amniotic fluid/maternal serum

A

Dating error, anencephaly, spina bifida (neural tube defects) [vs. Down syndrome, which has ⬇️ alpha-fetoprotein]

55
Q

Increased uric acid levels

A

Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics)

56
Q

Cowdry type A bodies

A

Intranuclear eosinophilic droplet-like bodies (HSV or CMV)

57
Q

Ferruginous bodies

A

Iron-containing nodules in alveolar septum (asbestosis: ⬆️ chance of mesothelioma, but lung cancer still more common among those exposed to asbestos)

58
Q

Squamous cell carcinoma

A

Keratin pearls on a skin biopsy

59
Q

Chèdiak-Higashi disease

A

Large lysosomal vesicles in phagocytes, immunodeficiency (congenital failure of phagolysosome formation)

60
Q

Ulcerative colitis

A

“Lead pipe” appearance of colon on barium enema x-ray (loss of haustra)

61
Q

Goodpasture’s syndrome

A

Linear appearance of IgG deposition on glomerular basement membrane

62
Q

Wilson’s disease

A

Low serum ceruloplasmin (hepatolenticular degeneration)

63
Q

Postreptococcal glomerulonephritis

A

“Lumpy bumpy” appearance of glomeruli on immunofluorescence (immune complex deposition of IgG and C3b)

64
Q

Multiple myeloma

A

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

65
Q

Fibrocystic change of breast

A

Mammary gland (“blue domed”) cyst

66
Q

Monoclonal antibody spike

A
  • Multiple myeloma (usually IgG or IgA)
  • Monoclonal gammopathy of undetermined significance (MGUS; normal consequence of aging)
  • Waldenström’s (M protein = IgM) macroglobulinemia
  • Primary amyloidosis
67
Q

Signet ring

A

Mucin-filled cell with peripheral nucleus (gastric carcinoma)

68
Q

“String sign”

A

Narrowing of bowel lumen on barium x-ray (Crohn’s disease)

69
Q

Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis

A

Granulomatous with polyangiitis (Wegener’s; c-ANCA positive) and Goodpasture’s syndrome (anti-basement membrane antibodies)

70
Q

Gout

A

Needle-shaped, negatively birefringent crystals (monosodium urate crystals)

71
Q

Kimmelstiel-Wilson nodules

A

Nodular hyaline deposits in glomeruli (diabetic nephropathy)

72
Q

Novobiocin response

A

Sensitive: Staphylococcus epidermidis; resistant: Staphylococcus saprophyticus

73
Q

“Nutmeg” appearance of liver

A

Chronic passive congestion of liver due to right heart failure

74
Q

Ewing’s sarcoma

A

“Onion ring” periosteal reaction (malignant round cell tumor)

75
Q

Optochin response

A

Sensitive: Streptococcus pneumoniae; resistant: Viridans streptococcus

76
Q

Codman’s triangle on x-ray

A

Periosteum raised from bone, creating triangular area (osteosarcoma, Ewing’s sarcoma, pyogenic osteomyelitis)

77
Q

Minimal change disease

A

Podocyte fusion or “effacement” on electron microscopy (child with nephrotic syndrome)

78
Q

Eburnation

A

Polished, “ivory like” appearance of bone at cartilage erosion (osteoarthritis resulting in bony sclerosis)

79
Q

Neurofibrillary tangles and Pick’s bodies

A

Protein aggregates in neurons from hyperphosphorylation of protein tau (neurofibrillary tangles: Alzheimer’s disease; Pick’s bodies: Pick’s disease)

80
Q

Psamomma bodies

A

Meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of the endometrium and ovary

81
Q

Gliobastoma multiforme

A

Pseudopalisading tumor cells on brain biopsy

82
Q

Acute glomerulonephritis

A

RBC casts in urine

83
Q

Reinke crystals

A

Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells (Leydig cell tumor)

84
Q

Acute toxic/viral nephrosis

A

Renal epithelial casts in urine

85
Q

Pseudogout

A

Rhomboid crystals, positively birefringent (calcium phosphate dihydrate crystals)

86
Q

Coarctation of the aorta

A

Rib notching

87
Q

Ring-enhancing brain lesion in AIDS

A

Toxoplasmosis gondii, CNS lymphoma

88
Q

Burkitt’s lymphoma

A

Sheets of medium-sized lymphoid cells with scattered pale, tingible body-laden macrophages (“starry sky” histology) (t[8:14] c-myc activation, associated with EBV; “black sky” made up of malignant cells)

89
Q

Pick bodies

A

Silver-staining spherical aggregation of tau proteins in neurons (Pick’s disease: progressive dementia, changes in personality)

90
Q

Giant cell tumor of bone

A

“Soap bubble” in femur or tibia on x-ray (generally benign)

91
Q

Membranous glomerulonephritis

A

“Spikes” on basement membrane, “dome like” subepithelial deposits (may progress to nephrotic syndrome)

92
Q

Rouleaux formation

A

Stacks of RBCs (high ESR, multiple myeloma)

93
Q

“Clue cells”

A

Stippled vaginal epithelial cells (Gardnerella vaginalis)

94
Q

Birbeck granules

A

“Tennis racket” shaped cytoplasmic organelles (EM) in Langerhans cells (Langerhans cell histiocytosis or hystiocytosis x: eosinophilic granuloma)

95
Q

Lines of Zahn

A

Thrombi made of white/red layers (arterial thrombus, layers of platelets/RBCs)

96
Q

Epiglottitis

A

“Thumb sign” on lateral x-ray (Haemophilus influenzae)

97
Q

Chronic bacterial pyelonephritis

A

Thyroid-like appearance of kidney

98
Q

Membranoproliferative glomerulonephritis

A

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

99
Q

Fatty liver disease

A

Triglyceride accumulation in liver cell vacuoles (alcoholic or metabolic syndrome)

100
Q

Chronic end-stage renal disease

A

“Waxy” casts with very low urine flow

101
Q

Acute pyelonephritis

A

WBC casts in urine

102
Q

CLL

A

WBCs that look smudged (almost always B cell)

103
Q

Lupus nephropathy

A

“Wire loop” glomerular capillary appearance on light microscopy

104
Q

Xanthochromia

A

Yellowish CSF (e.g., due to subarachnoid hemorrhage)

USMLE Rapid Review (5 decks)

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