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USMLE > 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 (e.g., hydralazine, isoniazid, phenytoin, procainamide)

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5
Q

Anti-IgG antibodies

A

Rheumatoid arthritis (systemic inflammation, joint pannus, boutonnière 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 polyangitis and eosinophilia granulomatosis with polyangitis (Churg-Strauss syndrome) (MPO-ANCA/p-ANCA);

Granulomatosis with polyangitis (Wegener; PR3-ANCA/c-ANCA)

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8
Q

Antinuclear antibodies (ANAs:anti-Smith and anti-dsDNA

A

SLE (type 3 hypersensitivity)

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9
Q

Anti-platelet antibodies

A

Idiopathic thrombocytopenic purpura

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10
Q

Anti-topoisomerase

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” lesionon barium enema x-ray

A

Colorectal cancer (usually left-sided)

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13
Q

Atypical lymphocytes

A

EBV

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14
Q

Azurophilic peroxidase positive granular inclusions in granulocytes and myeloblasts

A

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

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15
Q

Bacitracin response

A

Sensitive: Streptococcus pyogenes (group A)
Resistant: Streptococcus agalactiae (group B)

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16
Q

“Bamboo spine” on X-ray

A

Ankylosing spondylitis (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

Basophilic stippling of RBCs

A

Lead poisoning or sideroblastic anemia

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19
Q

Bloody or yellow tap on lumbar puncture

A

Subarachnoid hemorrhage

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20
Q

“Boot shaped” heart on x-ray

A

Tetralogy of Fallot (due to RVH)

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21
Q

Branching gram positive rods with sulfur granules

A

Actinomyces Israeli

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22
Q

Brochogenic apical lung tumor on imaging

A

Pancoast tumor (can compress cervical sympathetic chain and cause Horner syndrome)

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23
Q

“Brown” tumor of bone

A

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

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24
Q

Cardiomegaly with apical atrophy

A

Chagas’ disease (trypanosoma Cruzi)

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25
Q

Cellular crescents in bowman capsule

A

Rapidly progressive cresenteric glomerulonephritis

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26
Q

‘Chocolate cyst’ of ovary

A

Endometriosis (frequently involves both ovaries)

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27
Q

Circular Grouping of dark tumor cells surrounding pale neurofibrils

A

Homer-Wright rosettes (neuroblastoma, medulloblastoma)

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28
Q

Colonies of mucous Pseudomonas in lungs

A

Cystic fibrosis (AR mutation in CFTR gene—-> fat soluble vitamin deficiency and mucous plugs)

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29
Q

Decrease AFP in amniotic fluid/maternal serum

A

Down syndrome or other chromosomal abnormalities

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30
Q

Degeneration of dorsal column fibers

A

Tabes Dorsalis (tertiary syphilis)

Subacute combined degeneration of the spinal cord
(dorsal columns, lateral corticospinal, spinocerebellar tracts affected)

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31
Q

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

A

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

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32
Q

Depigmentation of neurons in substantia nigra

A

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

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33
Q

Desquamated epithelium casts in sputum

A

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

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34
Q

Disarrayed granulosa cells arranged around collections of eosinophilia fluid

A

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

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35
Q

Dysplastic squamous cervical cells with “rasinoid” nuclei and hyperchromasia

A

Koilocytes (HPV: predisposes to cervical cancer)

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36
Q

Electrical alternans (alternating amplitude on EKG)

A

Pericardial tamponade

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37
Q

Enlarged cells with intranuclear inclusion bodies

A

“Owl eye” appearance of CMV

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38
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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39
Q

Eosinophilic cytoplasmic inclusion in liver cell

A

Mallory body (alcoholic liver disease)

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40
Q

Eosinophilic cytoplasmic inclusion in nerve cell

A

Lewy body (Parkinson Disease)

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41
Q

Eosinophilic globule in liver

A

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

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42
Q

Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellum neurons

A

Negri bodies of rabies

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43
Q

Extracellular amyloid deposition in gray matter of brain

A

Senile plaques (Alzheimer’s disease)

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44
Q

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

A

Reed-Sternberg cells (Hodgkin lymphoma)

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45
Q

Glomerulus-like structure surround vessel in germ cells

A

Schiller-Duval bodies (yolk sac tumor)

46
Q

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

A

B-thalassemia, sickle cell Disease (marrow expansion)

47
Q

hCG elevate

A

Choriocarcionoma, hydatidiform mole (occurs with and without embryo, and multiple pregnancy).

48
Q

Heart nodules (granulomatous)

A

Aschoff bodies (Rhuematic fever)

49
Q

Heterophile antibodies

A

Infectious mononucleosis (EBV)

50
Q

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

A

Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)

51
Q

High level of D-dimers

A

DVT, PE,DIC

52
Q

Hilar lymphadenopathy, peripheral granulomatosis lesion in middle or lower Lung lobes (can calcify)

A

Ghon complex (primary TB: mycobacterium bacilli)

53
Q

“Honeycomb lung” on X-ray or CT

A

Interstitial pulmonary fibrosis

54
Q

Hypercoagulability (leading to migrating DVTs and vasculitis)

A

Trousseau syndrome (adenocarcinoma of pancreas or lung)

55
Q

Hypersegmented neutrophils

A

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

56
Q

Hypertension, hypokalemia, metabolic alkalosis

A

Conn syndrome (primary hyperaldosteronism)

57
Q

Hypochromic, microcytic anemia

A

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

58
Q

Increased AFPmin amniotic fluid or maternal serum

A

Dating error, anencephaly, spina bifida (NTDs)

59
Q

Increased Uris acid levels

A

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

60
Q

Intranuclear esosinophilc droplet-like bodies

A

Cowdry type A bodies (HSV or VZV)

61
Q

Iron-containing nodules in alveolar septum

A

Ferruginous bodies (asbestosis: increase chance of mesothelioma)

62
Q

Keratin pearls on skin biopsy

A

Squamous cell carcinoma

63
Q

Large granules in phagocytes, immunodeficiency

A

Chédiak-Higashi Disease (congenital failure of phagolysosome formation)

64
Q

“Lead pipe” appearance of colon on abdominal imaging

A

Ulcerative colitis (loss of haustra)

65
Q

Linear appearance of IgG deposition on glomerularnand alveolar basement membranes

A

Goodpasture syndrome

66
Q

Low serum ceruloplasmin

A

Wilson disease (hepatolenticular degeneration)

67
Q

“Lumpy bumpy” appearance of glomeruli on immunofluorescence

A

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

68
Q

Lytic “punched out” bone lesion on x-ray

A

Multiple Myeloma

69
Q

Mammary gland (“blue domed”) cyst

A

Fibrocystic change of the breast

70
Q

Monoclonal antibody spike

A
  • Multiple myeloma (usually IgG or IgA)
  • Monoclonal gammopathy of undetermined significance (MGUS consequence of aging)
  • Waldenström (M protein= IgM) macroglobulinemia
  • Primary amyloidosis
71
Q

Mucin-filled cell with peripheral nucleus

A

“Signet ring” (gastric carcinoma)

72
Q

Narrowing of bowel lumen on barium X-ray

A

String sign (Crohn Disease)

73
Q

Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis

A

Granulomatosis with polyangitis (Wegener; PR3-ANCA/c-ANCA)

Goodpasture syndrome (anti-basement membrane antibodies)

74
Q

Needle shaped, negative birefringrnt crystals

A

Gout (monosodium urate crystals)

75
Q

Nodular hyaline deposits in glomeruli

A

Kimmelstiel-Wilson nodules (diabetic nephropathy)

76
Q

Novobocin response

A

Sensitive: S.epidermidis
Resistant: S.saprophyticus

77
Q

“Nutmeg” appearance of liver

A

Chronic passive congestion of liver due to right heart failure or Budd-Chiari Syndrome

78
Q

“Onion skin” periosteal reaction

A

Ewing sarcoma (malignant small blue cell tumor)

79
Q

Optochin response

A

Sensitive: S.pnuemoniae
Resistant: Viridans strep (s.mutans, S.sanguis)

80
Q

Periosteum raised from bone, creating triangular area

A

Cod an triangle on X-ray , Ewing sarcoma, pyogenic osteomyelitis

81
Q

Podocyte fusion or effacement on electron microscopy

A

Minimal change Disease (child with nephrotic syndrome)

82
Q

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

A

Eburnation (osteoarthritis resulting in bony Sclerosis)

83
Q

Protein aggregates in neurons from hyperphosphorylation of tau protein

A

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

84
Q

Psammoma bodies

A

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

85
Q

Pseudopalisading tumor on brain biopsy

A

Glioblastoma Multiforme

86
Q

RBc casts in urine

A

Glomerulonephritis

87
Q

Rectangular, crystal like, cytoplasmic inclusions in Leydig cells

A

Reinke crystals (Leydig cell tumor)

88
Q

Recurrent infections, eczema, thrombocytopenia

A

Wiskott-Aldrich syndrome

89
Q

Renal epithelial casts in urine

A

Intrinsic renal failure (ischemic or toxic)

90
Q

Rhomboid crystals, positively birefringent

A

Psuedogout (calcium pyrophosphate dihydrate crystals)

91
Q

Rib notching

A

Coarctaion of the aorta

92
Q

Ring enhancing brain lesions in AIDS

A

Toxoplasma gondii, CNS lymphoma

93
Q

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

A

Burkitt lymphoma (t[8:14] c-myc activation, associated with EBV; “starry sky” made up of malignant cells)

94
Q

Silver-staining spherical aggregation of tau proteins in neurons

A

Pick bodies (pick Disease: progressive dementia, changes in personality)

95
Q

Soap bubble in femur or tibia on X-ray

A

Giant cell tumor of bone (generally benign)

96
Q

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

A

Membranous nephropathy (nephrotic syndrome)

97
Q

Stacks of RBCs

A

Rouleaux formation (high ESR, multiple myeloma)

98
Q

“Steeple” sign on CXR

A

Croup (parainfluenza virus)

99
Q

Stipples vaginal epithelial cells

A

“Clue cells” (Gardnerella vaginalis)

100
Q

Streptococcus bovis bacteremia

A

Colon cancer

101
Q

“Tennis racket-shaped cytoplasmic organelles in Langerhans cells

A

Birbeck granules (langerhans cell histiocytosis)

102
Q

Thousands of polyps on colonoscopy

A

Familial adenomatous polyposis (AD mutation of APC gene)

103
Q

Thrombi made of white/red layers

A

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

104
Q

“Thumb sign” on lateral neck X-ray

A

Epiglottitis (H.influenza)

105
Q

Thyroid-like appearance of kidney

A

Chronic pyelonephritis (usually due to recurrent infections)

106
Q

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

A

Membranoproliferative glomerulonephritis

107
Q

Triglyceride accumulation in liver cell vacuoles

A

Fatty liver disease (alcoholic or metabolic syndrome)

108
Q

Waxy casts with very low urine flow

A

Chronic end stage renal disease

109
Q

WBC casts in urine

A

Acute pyelonephritis

110
Q

WBCs that look smudged

A

CLL (almost always B cell)

111
Q

“Wire loop” glomerular capillary appearance on light microscopy

A

Diffuse glomerulonephritis (usually seen with lupus)

112
Q

Yellowish CSF

A

Xanthochromia (e.g. Due to subarachnoid hemorrhage)

USMLE (18 decks)

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