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STEP Rapid Review > Classic Labs/Findings > Flashcards

Classic Labs/Findings 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 (e.g. hydralazine, isoniazid, 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) (3)

A

Microscopic polyangiitis and eosinophilic granulomatosis with polyangiitis (Churg Strauss syndrome (MPO-ANCA/p-ANCA)
Granulomatosis with 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 (ITP)

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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, weight loss)

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12
Q

“Apple core” lesion on barium enema x-ray

A

Colorectal cancer (usually L sided)

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13
Q

Atypical lymphocytes

A

EBV

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14
Q

Azurophilic peroxidase + granular inclusions in granulocytes and myeloblasts

A

Auer rods (AML, especially promyelocytic M3 type)

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15
Q

Bacitracin response (2)

A

Sensitive: S. pyogenes (GAS)
Resistant: S. agalactiae (GBS)

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16
Q

“Bamboo spine” on x ray

A

Ankylosing spondyliitis (chronic inflammatory arthritis, HLA B27)

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17
Q

Basophilic nuclear remnants in RBCs

A

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

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18
Q

Bloody or yellow tap on LP

A

Subarachnoid hemorrhage

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19
Q

“Boot-shaped” heart on XR

A

Tetralogy of Fallot (due to 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 cervical sympathetic chain and cause Horner syndrome)

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22
Q

“Brown” tumor of bone

A

Hyperparathyroidism or osteitis fibrosa cystica (deposited hemosiderin from hemorhage 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)

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27
Q

Colonies of mucoid Pseudomonas in lungs

A

Cystic fibrosis (AR mut in CFTR gene yields 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 abnormalities

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29
Q

Degeneration of dorsal column fibers (2)

A

Tabes dorsalis (tertiary syphilis), subacute combined degeneration (dorsal columns, lateral corticospinal, spinocerebellar tracts affected)

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30
Q

“Delta wave” on EKG, short PR interval, supraventricular tachycardia

A

Wolf-Parkinson-White syndrom e(Bundle of Kent bypasses AV node)

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31
Q

Depigmentation of neurons in substantia nigra

A

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

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32
Q

Desquamated epithelium casts in sputum

A

Curschmann spiral (bronchial asthma, can result in worled mucous plugs)

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33
Q

Disarrayed granulosa cells arragned around collections of eosinophilic fluid

A

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

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34
Q

Dysplastic squamos cervical cells with “raisinoid” nuclei and hyperchromasia

A

Koilocytes (HPV: predisposes to cervical cancer)

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35
Q

Electrical alternans (alternating amplitude on EKG)

A

Pericardial tamponade

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36
Q

Enlarged cells with intranuclear inclusion bodies

A

“Owl eye” appearance of CMV

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37
Q

Enlarged thyroid cells with ground glass nuclei with central clearing

A

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

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38
Q

Eosinophilic cytoplasmic inclusion in liver cell

A

Mallory body (alcoholic liver disease)

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39
Q

Eosinophilic cytoplasmic inclusion in nerve cell

A

Lewy body (Parkinson disease)

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40
Q

Eosinophilic globule in liver

A

Councilman body (viral hepatitis, yellow fever), represents hepatocyte undergoing apoptosis

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41
Q

Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar neurons

A

Negri bodies of rabies

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42
Q

Extracellular amyloid deposition in gray matter of brain

A

Senile plaques (Alzheimer disease)

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43
Q

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

A

Reed-Sternberg cells (Hodgkin lymphoma)

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44
Q

Glomerulus-like structure surrounding vessel in germ cells

A

Schiller-Duval bodies (yolk sac tumor)

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45
Q

“Hair on end” (“crew cut”) appearance on x ray (2)

A

Beta thallassemia, sickle cell disease (marrow expansion)

46
Q

hCG elevated (2)

A

Choriocarcinoma, hydatidiform mole (occurs w/ and w/out embryo, and multiple pregnancy)

47
Q

Heart nodules (granulomatous)

A

Aschoff bodies (rheumatic fever)

48
Q

Heterophile antibodies

A

Infectious mononucleosis (EBV)

49
Q

Hexagonal, double pointed, needlie like crystals in bronchial secretions

A

Bronchail asthma (Charcot-Leyden crystals: eosinophilic granules)

50
Q

High level of D-Dimers (3)

A

DVT, PE, DIC

51
Q

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

A

Ghon complex (primary TB)

52
Q

“Honeycomb lung” on XR or CT

A

Interstitial pulmonary fibrosis

53
Q

Hypercoagulability (leading to migrating DVTs and vasculitis)

A

Trousseau syndrome (adenocarcinoma of pancreas or lung)

54
Q

Hypersegmented neutrophils (2)

A

Megaloblastic anemia (B12 def: neuro symtpoms, folate def: no neuro symptoms)

55
Q

Hypertension, hypokalemia, metabolic alkalosis

A

Conn syndrome (primary hyperaldosteronism)

56
Q

Hypochromic, microcytic anemia (3)

A

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

57
Q

Increased AFP in amniotic fluid/maternal serum (3)

A

Dating error, anencephaly, spina bifida (NTD)

58
Q

Increased uric acid levels (4)

A

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

59
Q

Intranuclear eosinophilic droplet-like bodies

A

Cowdry type A bodies (HSV or VZV)

60
Q

Iron-containing nodules in aveolar septum

A

Ferruginous bodies (asbestosis: increased chance of mesothelioma)

61
Q

Keratin pearls on a skin biopsy

A

Squamos cell carcinoma

62
Q

Large granules in phagocytes, immunodeficiency

A

Chediak-Higashi disease (congenital failure of phagolysosome formation)

63
Q

“Lead pipe” appearance of colon on abdominal imaging

A

Ulcerative colitis (loss of haustra)

64
Q

Linear appearance of IgG deposition on glomerular and alveolar basement membranes

A

Goodpasture syndrome

65
Q

Low ceruloplasmin

A

Wilson disease (hepatolenticular degeneration)

66
Q

“Lumpy bumpy” appearance of glomeruli on immunofluorescence

A

Poststreptococcal glomerulonephritis (due to deposition of IgG, IgM, and C3)

67
Q

Lytic (“punched out”) bone lesions on x ray

A

Multiple myeloma

68
Q

Mammary gland (“Blue domed”) cyst

A

Fibrocystic change of the breast

69
Q

Monoclonal antibody spike (4)

A 
Multiple myeloma (usually IgG or IgA)
Monoclonal gammopathy of undetermined significance (MGUS consequence of aging)
Waldenstrom (M protein = IgM) macroglobulinemia
Primary amyloidosis
70
Q

Mucin-filled cell with peripheral nucleus

A

“signet ring” (gastic carcinoma)

71
Q

Narrowing of bowel lumen on barium x ray

A

“String sign” (Crohn disease)

72
Q

Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis (2)

A

Granulomatosis with polyangiitis (Wegener, PR3-ANCA/c-ANCA) and Goodpasture syndrome (anti-BM antibodies)

73
Q

Needle-shaped, negatively birefringent crystals (yellow when aligned parallel, blue when across)

A

Gout (monosodium urate crystals)

74
Q

Nodular hyaline deposits in glomeruli

A

Kimmelstiel-Wilson nodules (diabetic nephropathy)

75
Q

Novobiocin response (2)

A

Sensitive: S. epidermidis
Resistant: S. saprophyticus

76
Q

“Nutmeg” appearance of liver (2)

A

Chronic passive congestion of liver due to RH failure or Budd-Chiari syndrome

77
Q

“Onion skin” periosteal reaction

A

Ewing sarcoma (malignant small blue cell tumor)

78
Q

Optochin response (2/3)

A

Sensitive: S. pneumoniae
Resistant: viridans streptococci (S. mutans, S. sanguis)

79
Q

Periosteum raised from bone, creating triangular area (2)

A

Codman triangle on x ray, Ewing sarcoma, pyogenic osteomyelitis

80
Q

Podocyte fusion or “effacement” on electron microscopy

A

Minimal change disease (child with nephrotic syndrome)

81
Q

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

A

Eburnation (osteoarthritis resulting in bony sclerosis)

82
Q

Protein agggregates in neurons from hyperphosphorylation of tau protein

A

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

83
Q

Psamomma bodies (4)

A

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

84
Q

Pseudopalisading tumor cells on brain biopsy

A

Glioblastoma multiforme

85
Q

RBC casts in urine

A

Glomerulonephritis

86
Q

Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells

A

Reinke crystals (Leydig cell tumor)

87
Q

Recurrent infections, eczema, thrombocytopenia

A

Wiskott-Aldrich syndrome

88
Q

Renal epithelial casts in urine

A

Intrinsic renal failure (like ischemia or toxic injury)

89
Q

Rhomboid crystals, positively birefringent (blue in parallel, yellow across)

A

Pseudogout (calcium pyrophosphate dihydrate crystals)

90
Q

Rib notching

A

Coarctation of the aorta

91
Q

Ring-enhancing brain lesion in AIDS (2)

A

Toxoplasma gondii, CNS lymphoma

92
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 activations, associated with EBV. Starry sky made up of malignant cells)

93
Q

Silver-staining spherical aggregation of tau proteins in neurons

A

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

94
Q

“Soap bubble” in femur or tibia on x ray

A

Giant cell tumor of bone (generally benign)

95
Q

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

A

Membranous nephropathy (nephrotic syndrome)

96
Q

Stacks of RBCs

A

Rouleaux formation (high ESR, multiple myeloma)

97
Q

“Steeple” sign on CXR

A

Croup (parainfluenza virus)

98
Q

Stippled vaginal epithelial cells

A

“Clue cells” (Gardnerella vaginalis)

99
Q

Streptococcus bovis bacteremia

A

Colon cancer

100
Q

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

A

Birbeck granules (Langerhans cell histiocytosis)

101
Q

Thousands of polyps on colonoscopy

A

FAP (AD mutation of APC gene)

102
Q

Thrombi made of white/red layers

A

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

103
Q

“Thumb sign” on lateral neck x ray

A

Epiglottis (H. influenzae)

104
Q

Thyroid-like appearance of kidney

A

Chronic pyelonephritis (usually due to recurrent infections)

105
Q

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

A

Membranoproliferative glomerulonephritis

106
Q

Triglyceride accumulation in liver cell vacuoles

A

Fatty liver disease (alcoholic or metabolic syndrome)

107
Q

“Waxy” casts with very low urine flow

A

Chronic end stage renal disease

108
Q

WBC casts in urine

A

Acute pyelonephritis

109
Q

WBCs that look “smudged”

A

CLL (almost always B cell)

110
Q

“Wire loop” glomerular capillary appearance on light microscopy

A

Diffuse proliferative glomerulonephritis (usually seen with lupus)

111
Q

Yellowish CSF

A

Xanthochromia (e.g. due to subarachnoid hemorrhage)

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