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First Aid - Rapid Review > Classic labs/findings > Flashcards

Classic labs/findings Flashcards

1
Q

Dec. AFP in amniotic fluid/maternal serum

A

Down syndrome

Edwards syndrome

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2
Q

Large granules in phagocytes, immunodeficiency

A

Chédiak-Higashi disease (congenital failure of

phagolysosome formation)

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3
Q

Recurrent infections, eczema, thrombocytopenia

A

Wiskott-Aldrich syndrome

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4
Q

Optochin sensitivity

A

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

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5
Q

Novobiocin response

A

Sensitive: S epidermidis; Resistant: S saprophyticus

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6
Q

Bacitracin response

A

Sensitive: S pyogenes (group A);
Resistant: S agalactiae (group B)

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7
Q

Streptococcus bovis bacteremia

A

Colon cancer

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8
Q

Branching gram + rods with sulfur granules

A

Actinomyces israelii

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9
Q

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

A

Ghon complex (1° TB: Mycobacterium bacilli)

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10
Q

“Thumb sign” on lateral neck x-ray

A

Epiglottitis (Haemophilus influenzae)

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11
Q

Bacteria-covered vaginal epithelial cells

A

“Clue cells” (Gardnerella vaginalis)

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12
Q

Cardiomegaly with apical atrophy

A

Chagas disease (Trypanosoma cruzi)

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13
Q

Atypical lymphocytes

A

EBV

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14
Q

Enlarged cells with intranuclear inclusion bodies

A

“Owl eye” appearance of CMV

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15
Q

Heterophile antibodies

A

Infectious mononucleosis (EBV)

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16
Q

Intranuclear eosinophilic droplet-like bodies

A

Cowdry type A bodies (HSV or VZV)

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17
Q

Eosinophilic globule in liver

A

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

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18
Q

“Steeple” sign on frontal CXR

A

Croup (parainfluenza virus)

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19
Q

Eosinophilic inclusion bodies in cytoplasm of

hippocampal and cerebellar neurons

A

Negri bodies of rabies

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20
Q

Ring-enhancing brain lesion on CT/MRI in AIDS

A
  1. Toxoplasma gondii

2. CNS lymphoma

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21
Q

Psammoma bodies

A
  1. Papillary thyroid carcinoma
  2. somatostatinoma
  3. meningioma
  4. mesothelioma
  5. ovarian serous papillary cystadenocarcinoma
  6. prolactinoma
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22
Q

“Delta wave” on ECG, short PR interval, supraventricular

tachycardia

A

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

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23
Q

“Boot-shaped” heart on

x-ray

A

Tetralogy of Fallot (due to RVH)

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24
Q

Rib notching (inferior surface, on x-ray)

A

Coarctation of the aorta

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25
Q

Heart nodules (granulomatous)

A

Aschoff bodies (rheumatic fever)

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26
Q

Electrical alternans (alternating amplitude on ECG)

A

Cardiac tamponade

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27
Q

Antineutrophil cytoplasmic antibodies (ANCAs)

A
  1. Microscopic polyangiitis and eosinophilic granulomatosis with polyangiitis (MPO-ANCA/p-ANCA);
  2. granulomatosis with polyangiitis (Wegener; PR3- ANCA/c-ANCA);
  3. primary sclerosing cholangitis (MPO-ANCA/
    p-ANCA)
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28
Q

Hypertension, hypokalemia, metabolic alkalosis

A

1° hyperaldosteronism (Conn syndrome)

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29
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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30
Q

Mucin-filled cell with peripheral nucleus

A

“Signet ring” (gastric carcinoma)

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31
Q

Anti-transglutaminase /

anti-gliadin / anti-endomysial antibodies

A

Celiac disease (diarrhea, weight loss)

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32
Q

Narrowing of bowel lumen on barium x-ray

A

“String sign” (Crohn disease)

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33
Q

“Lead pipe” appearance of colon on abdominal imaging

A

Ulcerative colitis (loss of haustra)

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34
Q

Thousands of polyps on colonoscopy

A

Familial adenomatous polyposis (autosomal dominant, mutation of APC gene)

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35
Q

“Apple core” lesion on barium enema x-ray

A

Colorectal cancer (usually left-sided)

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36
Q

Eosinophilic cytoplasmic inclusion in liver cell

A

Mallory body (alcoholic liver disease)

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37
Q

Triglyceride accumulation in liver cell vacuoles

A

Fatty liver disease (alcoholic or metabolic syndrome)

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38
Q

“Nutmeg” appearance of liver

A

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

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39
Q

Antimitochondrial antibodies (AMAs)

A

1° biliary cholangitis (female, cholestasis, portal hypertension)

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40
Q

Low serum ceruloplasmin

A

Wilson disease (hepatolenticular degeneration and Kayser- Fleischer rings due to copper accumulation)

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41
Q 
Migratory thrombophlebitis (leading to migrating DVTs
and vasculitis)
A

Trousseau syndrome (adenocarcinoma of pancreas or lung)

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42
Q

Basophilic nuclear remnants in RBCs

A

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

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43
Q

Basophilic stippling of RBCs

A
  1. Lead poisoning

2. Sideroblastic anemia

44
Q

Hypochromic, microcytic anemia

A
  1. Iron deficiency anemia
  2. Lead poisoning, 3. Thalassemia (fetal
    hemoglobin sometimes present)
45
Q

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

A
  1. Beta-thalassemia

2. Sickle cell disease (marrow expansion)

46
Q

Hypersegmented neutrophils

A

Megaloblastic anemia (B12 deficiency- neurologic symptoms; Folate deficiency- NO neurologic symptoms)

47
Q

Antiplatelet antibodies

A

ITP - Idiopathic thrombocytopenic purpura

48
Q

High level of D-dimers

A

DVT, PE, DIC

49
Q

Giant B cells with bilobed nuclei with prominent

inclusions (“owl’s eye”)

A

Reed-Sternberg cells (Hodgkin lymphoma)

50
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 activation, associated with EBV; “starry sky” made up of malignant cells)

51
Q

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

A

Multiple myeloma

52
Q

Monoclonal antibody spike

A
  1. Multiple myeloma (usually IgG or IgA)
  2. Monoclonal gammopathy of undetermined significance (MGUS- consequence of aging)
  3. Waldenström (M protein = IgM) macroglobulinemia
  4. Primary amyloidosis
53
Q

Stacks of RBCs

A

Rouleaux formation (high ESR, multiple myeloma)

54
Q 
Azurophilic peroxidase (+) granular inclusions in
granulocytes and myeloblasts
A

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

55
Q

WBCs that look “smudged”

A

CLL (almost always B cell)

56
Q

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

A

Birbeck granules (Langerhans cell histiocytosis)

57
Q

“Brown” tumor of bone

A

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

58
Q

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

A

Giant cell tumor of bone (generally benign)

59
Q

Raised periosteum (creating a “Codman triangle”)

A

Aggressive bone lesion (eg, osteosarcoma, Ewing

sarcoma, osteomyelitis)

60
Q

“Onion skin” periosteal reaction

A

Ewing sarcoma (malignant small blue cell tumor)

61
Q

Anti-IgG antibodies

A

Rheumatoid arthritis (systemic inflammation, joint pannus, boutonniere and swan neck deformities)

62
Q

Rhomboid crystals, (+) birefringent

A

Pseudogout (calcium pyrophosphate dihydrate crystals)

63
Q

Needle-shaped, (-) birefringent crystals

A

Gout (monosodium urate crystals)

64
Q

Elevated uric acid levels

A
  1. Gout
  2. Lesch-Nyhan syndrome
  3. Tumor lysis syndrome
  4. Loop and thiazide diuretics
65
Q

“Bamboo spine” on x-ray

A

Ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27)

66
Q

Antinuclear antibodies (ANAs: anti-Smith and antidsDNA)

A

SLE

type III hypersensitivity

67
Q

Anti-histone antibodies

A

Drug-induced SLE (eg, hydralazine, isoniazid,

phenytoin, procainamide)

68
Q

Anti-topoisomerase antibodies

A

Diffuse scleroderma

69
Q

Keratin pearls on a skin biopsy

A

Squamous cell carcinoma

70
Q

Bloody or yellow tap on lumbar puncture

A

Xanthochromia (due to subarachnoid hemorrhage)

71
Q

Eosinophilic cytoplasmic inclusion in neuron

A

Lewy body (Parkinson disease and Lewy body dementia)

72
Q

Extracellular amyloid deposition in gray matter of brain

A

Senile plaques (Alzheimer disease)

73
Q

Depigmentation of neurons in substantia nigra

A

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

74
Q

Protein aggregates in neurons from hyperphosphorylation

of tau protein

A
  1. Neurofibrillary tangles (Alzheimer disease)

2. Pick bodies (Pick disease)

75
Q

Silver-staining spherical aggregation of tau proteins in neurons

A

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

76
Q

Pseudopalisading tumor cells on brain biopsy

A

Glioblastoma multiforme

77
Q

Circular grouping of dark tumor cells surrounding pale neurofibrils

A

Homer-Wright rosettes (neuroblastoma, medulloblastoma)

78
Q

“Waxy” casts with very low urine flow

A

Chronic end-stage renal disease

79
Q

Nodular hyaline deposits in glomeruli

A

Kimmelstiel-Wilson nodules (diabetic nephropathy)

80
Q

Podocyte fusion or “effacement” on electron microscopy

A

Minimal change disease (child with nephrotic syndrome)

81
Q

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

subepithelial deposits

A

Membranous nephropathy (nephrotic syndrome)

82
Q

RBC casts in urine

A

Glomerulonephritis

83
Q

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

A

Membranoproliferative glomerulonephritis

84
Q

Anti–glomerular basement membrane antibodies

A 
Goodpasture syndrome (glomerulonephritis and
hemoptysis)
85
Q

Cellular crescents in Bowman capsule

A

Rapidly progressive (crescentic) glomerulonephritis

86
Q

“Wire loop” glomerular capillary appearance on light microscopy

A

Diffuse proliferative glomerulonephritis (usually seen with lupus)

87
Q

Linear appearance of IgG deposition on glomerular and alveolar basement membranes

A

Goodpasture syndrome

88
Q

“Lumpy bumpy” appearance of glomeruli on

immunofluorescence

A

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

89
Q

Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis

A
  1. Granulomatosis with polyangiitis (Wegener-PR3-ANCA / c-ANCA)
  2. Goodpasture syndrome (anti-basement
    membrane antibodies)
90
Q

Thyroid-like appearance of kidney

A 
Chronic pyelonephritis (usually due to recurrent
infections)
91
Q

WBC casts in urine

A

Acute pyelonephritis

92
Q

Renal epithelial casts in urine

A

Intrinsic renal failure (eg, ischemia or toxic injury)

93
Q

hCG elevated

A
  1. Choriocarcinoma

2. Hydatidiform mole (occurs with and without embryo, and multiple pregnancy)

94
Q

Dysplastic squamous cervical cells with “raisinoid” nuclei and hyperchromasia

A

Koilocytes

HPV: predisposes to cervical cancer

95
Q

Disarrayed granulosa cells arranged around collections of eosinophilic fluid

A

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

96
Q

“Chocolate cyst” of ovary

A

Endometriosis (frequently involves both ovaries)

97
Q

Mammary gland (“blue domed”) cyst

A

Fibrocystic change of the breast

98
Q

Glomerulus-like structure surrounding vessel in germ

cells

A

Schiller-Duval bodies (yolk sac tumor)

99
Q

Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells

A

Reinke crystals (Leydig cell tumor)

100
Q

Thrombi made of white/red layers

A

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

101
Q

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

A

Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)

102
Q

Desquamated epithelium casts in sputum

A

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

103
Q

“Honeycomb lung” on x-ray or CT

A

Idiopathic pulmonary fibrosis

104
Q

Colonies of mucoid Pseudomonas in lungs

A

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

105
Q

Iron-containing nodules in alveolar septum

A

Ferruginous bodies (asbestosis: inc. chance of lung cancer)

106
Q

Bronchogenic apical lung tumor on imaging

A

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

First Aid - Rapid Review (4 decks)

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