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NBME > Classic Labs/Findings > Flashcards

Classic Labs/Findings Flashcards

1
Q

Antinuclear antibodies (ANA: anti-Smith and anti-dsDNA)

A

SLE (type III hypersensitivity)

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2
Q

Anticentromere antibodies

A

Scleroderma (CREST)

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3
Q

Decreased alpha-fetoprotein in amniotic fluid/maternal serum

A

Down syndrome or other chromosomal abnormality

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4
Q

Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies

A

Celiac disease (diarrhea, distention, weight loss)

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5
Q

Azurophilic peroxidase-positive granular inclusions in granulocytes and myeloblasts

A

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

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6
Q

“Wire loop” glomerular capillary appearance on light microscopy

A

Lupus nephropathy

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7
Q

Stacks of RBCs

A

Rouleaux formation (high ESR, multiple myeloma)

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8
Q

Podocyte fusion or “effacement” on electron microscopy

A

Minimal change disease (child with nephrotic syndrome)

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9
Q

Hypersegmented neutrophils

A

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

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10
Q

Enlarged cells with intranuclear inclusion bodies

A

“Owl’s eye” appearance of CMV

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11
Q

Degeneration of dorsal column nerves

A

Tabes dorsalis (3o syphilis), subacute combine degeneration (dorsal columns and lateral corticospinal tracts affected)

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12
Q

“Honeycomb lung: on x-ray or CT

A

Interstitial pulmonary fibrosis

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13
Q

Extracellular amyloid deposition in gray matter of brain

A

Senile plaques (Alzheimer’s disease)

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14
Q

Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells

A

Reinke crystals (Leydig cell tumor)

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15
Q

Periosteum raised from bone, creating triangular area

A

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

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16
Q

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

A

Beta-thalassemia, sickly cell anemia (marrow expansion)

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17
Q

Eosinophilic globule in liver

A

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

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18
Q

Novobiocin response

A

Sensitive: Staphylococcus epidermidis

Resistant: Staphylococcus saprophyticus

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19
Q

Bloody tap on lumbar puncture (LP)

A

Subarachnoid hemorrhage

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20
Q

Bacitracin response

A

Sensitive: Streptococcus pyogenes (group A)

Resistant: Streptococcus agalacticae (group B)

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21
Q

“Thumb sign” on lateral x-ray

A

Epiglottitis (Haemophilus influenzae)

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22
Q

Mucin-filled cell with peripheral nucleus

A

Signet ring (gastric carcinoma)

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23
Q

“Spikes” on basement membrane, “dome like” sub epithelial deposits

A

Membranous glomerulonephritis (may progress to nephrotic syndrome)

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24
Q

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

A

Giant cell tumor of bone (generally benign)

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25
Q

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

A

Membranoproliferative glomerulonephritis

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26
Q

“Boot shaped” heart on x-ray

A

Tetralogy of Fallot, RVH

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27
Q

Cardiomegaly with apical atrophy

A

Chagas’ disease (Trypanosoma cruzi)

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28
Q

Disarrayed granulosa cells in eosinophilic fluid

A

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

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29
Q

Colonies of mucoid Pseudomonas in lungs

A

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

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30
Q

Anti-IgG antibodies

A

Rheumatoid arthritis (systemic inflammation, joint pannus, boutonniere deformity)

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31
Q

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

A

Burkitt’s lymphoma (t[8:14] c-myc activation, associated with EBV; “black sky’ made up of malignant cells)

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32
Q

“Bamboo spine” on x-ray

A

Ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27)

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33
Q

Rib notching

A

Coarction of the aorta

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34
Q

Large lysosomal vesicles in phagocytes, immunodeficiency

A

Chediak-Higashi disease (congenital failure of phagolysosome formation)

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35
Q

Intranuclear eosinophlic droplet-like bodies

A

Cowdry type A bodies (HSV or CMV)

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36
Q

Basophilic nuclear remnants in RBCs

A

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

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37
Q

WBC casts in urine

A

Acute pyelonephritis

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38
Q

Antiplatelet antibodies

A

Idiopathic thrombocytopenic purpura

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39
Q

Circular grouping of dark tumor cells surrounding pale neruofibrils

A

Homer-Wright rosettes (neuroblastoma, medulloblastoma, retinoblastoma)

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40
Q

Nodular hyaline deposits in glomeruli

A

Kimmelstiel-Wilson nodules (diabetic nephropathy)

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41
Q

“Lumpy bump” appearance of glomeruli on immunofluorescence

A

Poststreptococcal glomerulonephritis (immune complex deposition of IgG and C3b)

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42
Q

Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis

A

Granulomatosis with polyangiitis (Wegner’s; cANCA positive) and Goodpasture’s syndrome (anti-basement membrane antibodies)

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43
Q

Depigmentation of neurons in substantia nigra

A

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

44
Q

“Onion skin” periosteal reaction

A

Ewings sarcoma (malignant round-cell tumor)

45
Q

Desquamated epithelium casts in sputum

A

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

46
Q

Protein aggregates in neurons from hyperphosphorylation of protein tau

A

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

47
Q

“Brown” tumor of bone

A

Hyperparathyroidism or osteitis fibrosa cystica (deposited hemosiderin from hemorrhage gives brown color)

48
Q

Increased uric acid levels

A

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

49
Q

Antimitochondrial antibodies (AMAs)

A

1o biliary cirrhosis (female, cholestasis, portal hypertension)

50
Q

Keratin pearls on skin biopsy

A

Squamous cell carcinoma

51
Q

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

A

Ulcerative colitis (loss of haustra)

52
Q

Anti-topoisomerase antibodies

A

Diffuse system scleroderma

53
Q

Heart nodules (granulomatous)

A

Aschoff bodies (rheumatic fever)

54
Q

High levels of D-dimers

A

DVT, pulmonary embolism, DIC

55
Q

Rhomboid crystals, positively birefringent

A

Pseudogout (calcium pyrophosphate dihydrate crystals)

56
Q

Silver-staining spherical aggregation of tau proteins in neurons

A

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

57
Q

Branching gram-positive rods with sulfur granules

A

Actinomyces israelii

58
Q

RBC casts in urine

A

Acute glomerulonephritis

59
Q

Monoclonal antibody spike

A
  • Multiple myeloma (usually IgG or IgA) - Monoclonal gammopathy of undetermined significance (MGUS): normal consequence of aging - Waldenstrom’s (M protein=IgM) macroglobulinemia - Primary amyloidosis
60
Q

Yellowish CSF

A

Xanthochromia (e.g. due to subarachnoid hemorrhage)

61
Q

Narrowing of bowel lumen on barium x-ray

A

“String sign” (Crohn’s disease)

62
Q

Eosinophilic cytoplasmic inclusion in nerve cell

A

Lewy body (Parkinson’s disease)

63
Q

hCG elevated

A

Choriocarcinoma, hydatidiform mole (occurs with and without embryo)

64
Q

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

A

Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)

65
Q

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

A

Eburnation (osteoarthritis resulting in bony sclerosis)

66
Q

Bronchogenic apical lung tumor on imaging

A

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

67
Q

Renal epithelial casts in urine

A

Acute toxic/viral nephrosis

68
Q

“Nutmeg” appearance of liver

A

Chronic passive congestion of liver due to right heart failure

69
Q

Needle-shaped, negatively birefringent crystals

A

Gout (monosodium urate crystals)

70
Q

Mammary gland (“blue domed”) cyst

A

Fibrocystic change of the breast

71
Q

Thrombi made of white/red layers

A

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

72
Q

Antidesmoglein (epithelial) antibodies

A

Pemphigus vulgaris (blistering)

73
Q

Hypertension, hypokalemia, metabolic alkalosis

A

Conn’s syndrome

74
Q

Thyroid-like appearance of kidney

A

Chronic bacterial pyelonephritis

75
Q

Pseudopalisading tumor cells on brain biopsy

A

Glioblastoma multiforme

76
Q

“Waxy” casts with very low urine flow

A

Chronic end-stage renal disease

77
Q

Ring-enhancing brain lesion in AIDS

A

Toxoplasma gondii, CNS lymphoma

78
Q

Cellular crescents in Bowman’s capsule

A

Rapidly progressive crescentic glomerulonephritis

79
Q

“Apple core” lesion on abdominal x-ray

A

Colorectal cancer (usually left-sided)

80
Q

Optochin response

A

Sensitive: Streptococcus pneumoniae

Resistant: Viridians streptococcus

81
Q

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

A

Reed-Sternberg cells (Hodgkin’s lymphoma)

82
Q

Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia

A

Koilocytes (HPV: predisposes to cervical cancer)

83
Q

“Tenis racket” shaped cytoplasmic organelles seen in Langerhans cells on electron microscopy

A

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

84
Q

Hypercoagulability (leading to migrating DVTs and vasculitis)

A

Trousseau’s syndrome (adenocarcinoma of the pancreas or lung)

85
Q

Stippled vaginal epithelial cells

A

“Clue cells” (Gardnerella vaginalis)

86
Q

Eosinophilic cytoplasmic inclusion of liver cell

A

Mallory bodies (alcoholic liver disease)

87
Q

Basophilic stippling of RBCs

A

Lead poisoning or sideroblastic anemia

88
Q

Enlarged thyroid cells with ground-glass nuclei

A

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

89
Q

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

A

Ghon complex (1o TB: Mycobacterium bacilli)

90
Q

“Chocolate cyst” of ovary

A

Endometriosis (frequently involves both ovaries)

91
Q

Iron-containing nodules in alveolar septum

A

Ferruginous bodies (asbestosis: increased chance of mesothelioma)

92
Q

WBCs that looked “smudged”

A

CLL (almost always B cell)

93
Q

Low serum ceruloplasmin

A

Wilson’s disease (hepatolenticular degeneration)

94
Q

Heterophile antibodies

A

Infectious mononucleosis (EBV)

95
Q

Glomerulus-like structure surrounding vessel in germ cells

A

Schiller-Duval bodies (yolk sac tumor)

96
Q

Antihistone antibodies

A

Drug-induced SLE (hydrazine, isoniazid, phenytoin, procainamide)

97
Q

Triglyceride accumulation in liver cell vacuoles

A

Fatty liver disease (alcoholic or metabolic syndrome)

98
Q

Hypochromic, normocytic anemia

A

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

99
Q

Antineutrophil cytoplasmic antibodies (ANCAs)

A

Vasculitis (c-ANCA: granulomatosis with polyangiitis [Wegner’s]; p-ANCA: microscopic polyangiitis, Churg-Strauss syndrome)

100
Q

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

A

Multiple myeloma

101
Q

Linear appearance of IgG deposition on glomerular basement membrane

A

Goodpasture’s syndrome

102
Q

Anti-glomerular basement membrane antibodies

A

Goodpasture’s syndrome (glomerulonephritis and hemoptysis)

103
Q

Psammoma bodies

A

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

104
Q

Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells

A

Negri bodies of rabies (Lyssavirus [Rhabdoviridae])

105
Q

Increased alpha-fetoprotein in amniotic fluid/maternal serum

A

Dating error, anencephaly, spin bifid (neural tube defects)

NBME (5 decks)

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