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Step 1 Prep > Classic presentations > Flashcards

Classic presentations Flashcards

1
Q

Abdominal pain, ascites, hepatomegaly

A

Budd-Chiari syndrome (post-hepatic venous thrombosis)

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2
Q

Achilles tendon xanthoma

A

Familial hypercholesterolemia (decreased LDL receptor signaling)

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3
Q

Adrenal hemorrhage, hypotension, DIC

A

Waterhouse-Friderichsen syndrome (meningococcemia)

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4
Q

Arachnodactyly, lens dislocation, aortic dissection, hyperflexible joints

A

Marfan’s syndrome (fibrllin)

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5
Q

Athlete with polycythemia

A

2/2 EPO injection

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6
Q

Back pain, fever, night sweats, weight loss

A

Pott’s disease 2/2 vertebral TB

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7
Q

Bilateral hilar LAD & uveitis

A

Sarcoidosis (non-caseating granuloma)

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8
Q

Blue sclera

A

OI (type 1 collagen defect)

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9
Q

Bluish line on gingiva

A

Burton’s line (lead poisoning)

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10
Q

Bone pain, bone enlargement, arthritis

A

Paget’s disease (increased blastic and clastic activity)

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11
Q

Bounding pulses, diastolic murmur, head bobbing

A

AR

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12
Q

Butterfly facial rash and Raynaud’s phenomenon in a young female

A

SLE

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13
Q

Cafe-au-lait spots, Lisch nodules (iris hamartoma)

A

NF-1 (plus pheochromocytoma, optic glioma)

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14
Q

Cafe-au-lait spots, polyostotic fibrous dysplasia, precocious puberty, multiple endocrine abnormalities

A

McCune-Albright syndrome (mosaic G-protein signaling mutation)

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15
Q

Calf pseudohypertropy

A

Muscular dystrophy (Duchenne)

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16
Q

Cherry-red spot macula

A

Tay Sachs (ganglioside)
Niemann-Pick (sphingomyelin)
Central retinal artery occlusion

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17
Q

Chest pain on exertion

A

Angina (stable: moderate; unstable: mild)

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18
Q

Chest pain, pericardial effusion/friction rub, persistent fever following MI

A

Dressler’s syndrome (AI-mediated post MI fibrinous pericarditis): 1-12 weeks following AMI

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19
Q

Child uses arms to stand up from squat

A

Gower’s sign: DMD

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20
Q

Child with fever later develops rash on face that spreads to body

A

Parvovirus B19/Erythema infeciosum/Fifth disease “slapped cheek”

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21
Q

Chorea, dementia, caudate degeneration

A

Huntington’s disease (AD CAG-repeat)

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22
Q

Chronic exercise intolerance with myalgia, fatigue, painful cramps, myoglobinuria

A

McArdle’s disease (muscle glycogen phosphorylase deficiency)

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23
Q

Cold intolerance/sensitivity

A

Hypothyroidism

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24
Q

Conjugate lateral gaze palsy; horizontal diplopia

A

Internuclear opthalmoplegia (damage to MLF)
Bilateral: MS
Unilateral: stroke

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25
Q

Continuous machinery heart murmur

A

PDA (close with indomethacin; open with misoprostol)

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26
Q

Cutaneous edema 2/2 CT deposition

A

Myxedema (hypothyroidism, Grave’s – pre-tibial)

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27
Q

Dark purple skin/mouth nodules

A

Kaposi’s sarcoma (HHV-8)

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28
Q

Deep, labored breathing/hyperventilation

A

Kussmaul breathing (DKA)

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29
Q

Dermatitis, dementia, diarrhea

A

Pellagra (B3 deficiency)

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30
Q

Dilated CM, edema, alcoholism/malnutrition

A

Wet beriberi (B1 deficiency)

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31
Q

Dog/cat bite resulting in infection

A

Pasturella multocida (cellulitis at site of innoculation)

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32
Q

Dry eyes, mouth, arthritis

A

Sjogren’s (AI exocrine glands)

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33
Q

Dysphagia, glossitis, Fe-deficiency anemia

A

Plummer-Vinson syndrome (may progress to esophageal SCC)

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34
Q

Elastic skin, hypermobility of joints

A

EDS (type 3 collagen)

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35
Q

Enlarged, hard left supraclavicular LN

A

Vircow’s node (abdominal mets)

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36
Q

Erythroderma, LAD, HSM, atypical T cells

A

Sezary syndrome (cutaneous T-cell lymphoma) or mycosis fungoides

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37
Q

Facial muscle spasm upon tapping

A

Chovstek’s sign (hypocalcemia)

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38
Q

Fat, female, forty, fertile

A

Cholelithiasis (gall stones)

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39
Q

Fever, chills, headache, myalgia 2/2 ABX treatment for syphillis

A

Jarisch-Herxheimer reaction: rapid lysis of spirochetes; toxin release

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40
Q

Fever, cough, conjunctivitis, coryza, diffuse rash

A

Measles

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41
Q

Fever, night sweats, weight loss

A

B symptoms (lymphoma)

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42
Q

Fibrous plaques in soft tissue of penis

A

Peyronie’s disease (CT disorder)

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43
Q

Gout, mental retardation, self-mutaliting behavior in boy

A

Lesch.Nyan syndrome (HGPRT XLR)

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44
Q

Green-yellow rings around peripheral cornea

A

KF rings (Wilson’s disease - Cu)

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45
Q

Hamartomatous GI polyps, hyperpigmentation of mouth, hands, feet

A

Peutz-Jegher’s syndrome (inherited, benign polyposis can cause bowel obstruction; higher cancer risk, mainly GI)

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46
Q

HSM, osteoporosis, neurological symptoms

A

Gaucher’s disease (glucocerebrosidase deficiency)

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47
Q

Hereditary nephritis, sensorineural hearing loss, cataracts

A

Alport syndrome (can’t see, can’t pee, can’t climb a tree: alpha-chain of collagen 4)

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48
Q

Hyperphagia, hypersexuality, hyperorality loss, cataracts

A

Kluver-Bucy sydrome (bilataral amygdala lesion)

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49
Q

Hyperreflexia, hypertonia, Babinski sign

A

UMN lesion

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50
Q

Hyporeflexia, hypotonia, atrophy, fasiculations

A

LMN lesion

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51
Q

Hypoxemia, polycythemia, hypercapnia

A

Blue bloater: chronic bronchitis

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52
Q

Indurated, ulcerated genital lesion

A

Painful: H. ducreyi (chancroid)
Painless: Syphillis (T. pallidum)

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53
Q

Infant with cleft lip/palate; microcephaly/holoprosencephaly, polydactyly, cutis aplasia

A

Patau’s syndrome (Trisomy 13)

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54
Q

Carcinogen: Aflatoxin (Aspergillus)

A

Liver: HCC

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55
Q

Carcinogen: Alkylating agents

A

Blood: Leukemia/Lymphoma

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56
Q

Carcinogen: Aromatic amines (benzidine, 2-naphthylamine)

A

Bladder: TCC

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57
Q

Carcinogen: Arsenic

A

Liver: Angiosarcoma
Lung: Ca
Skin: SCC

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58
Q

Carcinogen: Asbestos

A

Lung: bronchogenic > mesothelioma

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59
Q

Carcinogen: Carbon tetrachloride

A

Liver: centrilobular necrosis, fatty change

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60
Q

Carcinogen: Cigarette smoke

A

Bladder (TCC)/Esophagus (SCC) /Kidney (RCC)/Larynx, Lung (SCC) /Pancreas (AC)

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61
Q

Carcinogen: Ethanol

A

Liver: HCC

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62
Q

Carcinogen: Ionizing radiation

A

Thyroid: Papillary thyroid cancer

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63
Q

Carcinogen: Nitrosamines (smoked foods)

A

Stomach cancer

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64
Q

Carcinogen: Radon

A

Lung cancer (second leading cause to lung cancer)

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65
Q

Carcinogen: Vinyl chloride

A

Liver: Angiosarcoma

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66
Q

Carcinogens associated with hepatic angiosarcoma

A
  1. Vinyl chloride

2. Arsenic

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67
Q

Infant with FTT, HSM and neurodegeneration

A

Niemann-Pick disease (genetic sphingomyelinase deficiency)

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68
Q

Infant with hypoglycemia, FTT and HSM

A

Cori’s disease (debranching enzyme)

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69
Q

Infant with microcephaly, rocker-bottom feet, clenched hands, and structural heart defect

A

Edward’s syndrome (trisomy 18)

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70
Q

Jaundice, palpable distended non-tender gall bladder

A

Courvoisier’s sign (distal obstruction of biliary tree)

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71
Q

Large rash with bull’s eye appearance

A

Erythema migrans (Ixodes tick/Lyme disease)

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72
Q

Lucid interval after traumatic brain injury

A

Epidural hematoma

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73
Q

Male child, recurrent infections, no mature B cells

A

Bruton’s X-linked agammaglobulinemia

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74
Q

Mucosal bleeding and prolonged bleeding time

A

Glanzmann’s thrombasthenia (Gp2b/3a platelet aggregation)

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75
Q

Muffled heart sounds, distended neck veins, hypotension

A

Beck’s triad of cardiac tamponade

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76
Q

Multiple colon polyps, osteomas/soft tissue tumors, impacted/supernumerary teeth

A

Gardner’s syndrome (subtype of FAP)

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77
Q

Infantile hypertrophic cardiomyopathy; exercise intolerance

A

Pmpe’s disease (lysosomal alpha-1,4, glucosidase deficiency)

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78
Q

Neonate w/ arm paralysis following difficult birth

A

Erb-Duchenne palsy (superior trunk, C5-6 brachial plexus injury – waiter’s tip)

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79
Q

No lactation post-partum, absent menstruation, cold intolerance

A

Sheehan’s pituitary infarction

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80
Q

Nystagmus, intention tremor, scanning speech, bilateral internuclear opthalmoplegia

A

MS

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81
Q

Oscillating slow/fast breathing

A

Cheyne-Stokes (central apnea in CHF or raiced ICP)

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82
Q

Painful blue fingers/toes, hemolytic anemia

A

Cold agglutinin disease (AIHA 2/2 M. pna or Mono)

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83
Q

Painful, pale, cold fingers/toes

A

Raynaud’s phenomenon (vasospasm in extremities)

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84
Q

Painful, raised red lesions on pads of fingers, toes

A

Osler’s node (immune complex)

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85
Q

Painless erythematous rash on palms and soles

A

Janeway lesions (infective endocarditis, septic emboli, microabscess)

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86
Q

Painless jaundice

A

Pancreatic ca obstructing bile duct

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87
Q

Palpable purpura on buttocks, joint pain, abdominal pain, hematuria

A

HSP (IgA vasculitis)

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88
Q

Pink puffer with dyspnea and hyperventilation

A

Emphysema: centriacinar (smoking)

Panacinar (A1AT)

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89
Q

Polyuria, RTA type 2, growth failure, electrolyte imbalances, hypophosphatemic rickets

A

Fanconi’s syndrome (proximal tubular reabsorption defect)

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90
Q

Positive anterior drawer sign

A

ACL injury

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91
Q

Pruritic, purple, polygonal planar papules and plaques

A

Lichen planus

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92
Q

Ptosis, miosis, anhydrosis

A

Horner’s syndrome

93
Q

Pupil accomodates, but does not react

A

Argyll Robertson pupil

94
Q

Rapidly progressive leg weakness that ascends following GI/URT infection

A

GBS

95
Q

Rash on palms and soles

A

Coxsackie A, RMSF, Syphillis

96
Q

Recurrent colds, unusual eczema, high IgE

A

Hyper IgE syndrome (Job syndrome: neutrophil chemotaxis abnormality)

97
Q

Red currant jely sputum in ETOH/DM patients

A

Klebsiella

98
Q

Red currrant jelly stools (adults vs. infants)

A

Acute mesenteric ischemia (adults); intussusception (infants)

99
Q

Red, itchy, swollen rash of nipple/areola

A

Paget’s disease of the breast (underlying neoplasm)

100
Q

Red urine in the morning, fragile RBC’s

A

PNH

101
Q

RCC (B/L), hemangioblastoma, angiomatosis, pheo

A

VHL (AD TS gene mutation)

102
Q

Resting tremor, rigidity, akinesia, postural instability

A

Parkinson’s disease

103
Q

Retinal hemorrhage with pale centers

A

Roth spots (bacterial endocarditis)

104
Q

Severe jaundice in a neonate

A

Crigler-Najjar

105
Q

Severe RLQ pain with palpation of LLQ

A

Rovsing sign

106
Q

Severe RLQ pain with RB tenderness

A

McBurney’s sign

107
Q

Short stature, high incidence of tumors/leukemia, aplastic anemia

A

Fanconi’s anemia (genetic loss of DNA cross link repair) often progresses to AML

108
Q

Single palmar crease

A

Down’s syndrome

109
Q

Situs inversus, chronic sinusitis, bronchiectasis, infertility

A

Kartagener’s syndrome (dyein arm)

110
Q

Skin hyperpigmentation, hypotension, fatigue

A

Addison’s disease

111
Q

Slow, progressive muscle weakness in boys

A

Becker’s MD (X-linked missense)

112
Q

Small, irregulat spots on buccal/lingual mucosa with blue-white centers

A

Koplik’s spots

113
Q

Splinter hemorrhages in fingernails

A

Endocarditis

114
Q

Strawberry tongue (3 associations)

A

Scarlet fever, Kawasaki disease, TSS

115
Q

Streak ovaries, congenital heart disease, horseshoe kidney, cystic hygroma, short stature, webbed neck, lymphedema

A

Turner syndrome (45, XO)

116
Q

Sudden swollen/painful big toe joint, tophi

A

Gout

117
Q

Swollen gums, mucosal bleeding, poor wound healing, spots on skin

A

Scurvy (vitamin C; cannot hydroxylate proline/lysine for collagen synthesis)

118
Q

Swollen, hard, painful finger joints

A

OA (osteophytes on PIP = Bouchard; DIP = Heverden’s)

119
Q

Systolic ejection murmur

A

AS

120
Q

Toe extension, fanning upond plantar scrape

A

Babinski sign (UMN)

121
Q

Urethritis, conjunctivitis, arthritis in a male

A

Reactive arthritis (HLA-B27)

122
Q

Vascular birthmark (port wine stain)

A

Hemangioma (benign, but associated with Sturge-Weber syndrome)

123
Q

Vomiting blood following GE lacerations

A

MW syndrome (ETOH anb bulimic)

124
Q

Weight loss, diarrhea, fever, arthritis, adenopathy

A

Whipple’s disease

125
Q

Worst headache of my life

A

SA hemorrhage

126
Q

Anticentromere Ab

A

Scleroderma (CREST)

127
Q

Anti-desmoglein Ab

A

Pemphigus vulgaris

128
Q

Anti-GBM

A

Goodpasture’s syndrome

129
Q

Anti-histone Ab

A

Drug induced SLE: hydralazine, INH, phenytoin, procainamide

130
Q

Anti-IgG Ab

A

RA

131
Q

Anti-mitochondrial Ab

A

Primary biliary cirrhosis (female, choestasis, portal hypertension)

132
Q

C-ANCA

A

Wegener’s granulomatosis

133
Q

P-ANCA

A

Churg-Strauss, Microscopic polyangiitis

134
Q

ANA

A

SLE

135
Q

Anti-platelet Ab

A

Idiopathic thrombocytopenic prpura

136
Q

Anti-topoisomerase Ab

A

Diffuse systemic scleroderma

137
Q

Anti-transglutaminase Ab

A

Celiac

138
Q

Anti-gliadin Ab

A

Celiac

139
Q

Anti-Endomysial Ab

A

Celiac

140
Q

Apple core lesion on AXR

A

Left-sided colorectal cancer

141
Q

Azurophilic peroxidase positive granular inclusions in granuloycytes and myeloblastis

A

Auer rods: AML (especially APML)

142
Q

Bamboo spine on X-ray

A

Ankylosing spondylitis (HLA-B27)

143
Q

Basophilic nuclear remnants in RBC

A

Howell-Jolly bodies (2/2 auto or actual splenectomy)

144
Q

Basophilic stippling of RBC

A

Lead poisoning or sideroblastic anemia

145
Q

Bloody tap on LP

A

SA hemorrhage

146
Q

Boot shaped heart on X-ray

A

TOF, RVH

147
Q

Branching gram-positive rods with sulfur granules

A

Actinomyces israelii

148
Q

Bronchogenic apical lung tumor on imaging

A

Pancoast tumor

149
Q

Brown tumor of bone

A

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

150
Q

Cardiomegaly with apical atrophy

A

Chagas disease (T. cruzi)

151
Q

Chocolate cyst of ovary

A

Endometriosis

152
Q

Circular grouping of dark tumor cells surrounding pale neurofibrils

A

Homer-Writght rosettes (neuroblastoma, medulloblastoma, Rb)

153
Q

Colonies of mucoid Pseudomonas in lungs

A

CF

154
Q

Decreased AFP in AF or maternal serum

A

Down Syndrome

155
Q

Degeneration of dorsal columns

A

Tabes dorsalis

156
Q

Depigmentation of neurons in SN

A

Parkinson’s diease

157
Q

Desquamated epithelial casts in sputum

A

Curschmann’s spirals (asthma)

158
Q

Disarrayed granulosa cells in eosinophilic fluid

A

Call-Exner bodies (GT cells of ovarian tumor)

159
Q

Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia

A

Koilocytes

160
Q

Enlarged cells with intranuclear inclusions

A

CMV Owl’s eye

161
Q

Enlarged thyroid cells with ground glass nuclei

A

Orphan Annie Eyes (papillary thyroid cancer)

162
Q

Eosinophilic intracytoplasmic inclusion of liver cell

A

Mallory body (ETOH)

163
Q

Eosinophilic intracytoplasmic inclusion of nerve cell

A

Lewy body (Parkinson’s)

164
Q

Eosinophilic globule in liver

A

Councilman body (hepatitis or yellow fever)

165
Q

Eosinophilic intracytoplasmic inclusion of hippocampal nerve cells

A

Negri bodies of rabies; Lyssavirus

166
Q

Extracellular amyloid deposition in gray matter of brain

A

Alzheimer’s senile plaques

167
Q

Giant B cells with owl’s eye prominent inclusions

A

RS cells: HL

168
Q

Glomerulus like structure surrounding vessel in germ cell

A

Schiller-Duval bodies: yolk sac tumor

169
Q

Hair on end (crew cut appearance) on skull xray

A

Beta-thal or SCA (marrow expansion)

170
Q

HCG elevated

A

Choriocarcinoma, hydatidiform mole

171
Q

Heart nodules (granulomatous)

A

Aschoff bodies (Rheumatic Fever)

172
Q

Heterophile Ab

A

Mono; EBV

173
Q

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

A

Bronchial asthma (Charcot-Leyden crystals – eosiniphilic granules)

174
Q

High levels of d-dimers

A

DVT, PE, DIC

175
Q

Hilar LAD, peripheral granulomatous lesion in middle or lower lung lobes

A

Primary TB

176
Q

Honeycombing on lung on CT or X-ray

A

Interstitial pulmonary fibrosis

177
Q

Hypercoagulability (leading to migrating DVTS and vascultitis)

A

Trousseau’s syndrome (AC lung or pancreas)

178
Q

Hypersegmented neutrophils

A

Megaloblastic anemia (B12 or folate)

179
Q

Hypochromic, microcytic anemia

A

Fe, Lead, thalassemia

180
Q

Increased AFP in maternal serum

A

Dating error, anencephaly, NTD

181
Q

HTN, hpokalenia, metabolic alkalosis

A

Conn’s syndrome

182
Q

Increased uric acid levels

A

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

183
Q

Intranuclear eosinophilic droplet-like bodies

A

Cowdry A inclusions (HSV or CMV)

184
Q

Iron-containing nodules in alveolar septum

A

Ferruginou bodies (asbestosis)

185
Q

Keratin pearls on skin biopsy

A

SCC

186
Q

Large lysosomal vesicles in phagocytes; immunodeficiency

A

Chediak-Higashi (phagolysosome)

187
Q

Lead pip appearance of colon on barium enema X-ray

A

UC

188
Q

Linear IgG on GBM

A

Goodpasture’s syndrome

189
Q

Low serum ceuloplasmin

A

Wilson’s disease

190
Q

Lumpy bumpy appearance of glomeruli on IF

A

PSGN (IgG, C3)

191
Q

Lytic “punched out” lesions on X-ray

A

Multiple myeloma

192
Q

Mammary gland “blue domed” cyst

A

FCC breast

193
Q

Monoclonal Ab spike

A

MM (IgG or IgA)
MGUS
IgM Waldenstrom’s
Primary amyloidosis

194
Q

Mucin-filled cell with peripheral nucleus

A

Signet cell

195
Q

Narrowing of bowel lumen on barium X-ray (String sign)

A

Crohn’s disease

196
Q

Necrotizing vasculitis and necrotizing GN

A

Wegener’s (c-ANCA); Goodpasture’s

197
Q

Needle-shaped, negative birefringent crystals

A

Gout

198
Q

Nodular hyaline deposits in glomeruli

A

KW nodules: DM nephropathy

199
Q

Nutmeg liver

A

Chronic passive congestion 2/2 RHF

200
Q

Onion skin periosteal reaction

A

Ewing’s sarcoma (malignant round cell tumor)

201
Q

Periosteum raised from bone, creating triangular area

A

Codman’s triangle (OS, Ewings, pyogenic OM)

202
Q

Podocyte effacement on EM

A

MCD

203
Q

Polished, ivory-like appearance of bone at cartilage erosion

A

Eburnation (OA resulting in bony sclerosis)

204
Q

Protein aggregates in neurons from hyperphosphorylated tau proteins

A

NF tangles & Pick bodies

205
Q

Psammoma bodies

A

Meningioma, Papillary thyroid cancer, mesothelima, papillary serous ca ovary/endometrium

206
Q

Pseudopalisading tumor cells on brain bx

A

GBM

207
Q

RBC casts in urine

A

Nephritic syndrome

208
Q

Rectangular, crystal-like cytoplasma inclusions in Leydig cells

A

Reinke crystals (Leydig cell tumor)

209
Q

Renal epithelial casts in urine

A

Acute toxic/viral nephrosis

210
Q

Rhomboid crystals, positively birefringent

A

Pseudogout; Ca pyropp hihydrate

211
Q

Rib notching

A

Coarctation of aorta

212
Q

Ring-enhancing brain lesion in AIDS

A

Toxoplasma, CNS lymphoma

213
Q

Sheets of medium-sized lymphoid cells with scater pale, tingibile body-laden macrophages

A

Burkitt’s lymphoma

214
Q

Silver staining spherical aggregation of tau proteins in neurons

A

Pick bodies

215
Q

Soap bubble in femur or tibia on X-ray

A

Giant cell tumor of bone

216
Q

Spike & dome on GBM

A

Membranous nephropathy

217
Q

Stacks of RBC’s

A

Rouleaux formation: MM

218
Q

Stippled vaginal epithelial cells

A

Clue cells (Gardenella)

219
Q

Tennis racket shaped cytoplasmic organelles in Langerhans cells

A

Birbeck granules: Langerhans cell histiocytosis

220
Q

Thrombi made of white/red layers

A

Lines of Zahn (arterial thrombus)

221
Q

Thumb sign on lateral X-ray

A

Epiglottitis

222
Q

Thyroid-like appearance of the kidney

A

Chronic bacterial pyelonephritis

223
Q

Tram-track capillary loops of GBM

A

MPGN

224
Q

Triglyceride accumulation in liver cell vacuoles

A

Fatty liver disease

225
Q

Waxy casts with very low urine flow

A

ESRD

226
Q

WBC casts in urine

A

Acute pyelonephritis

227
Q

WBC’s that look smudged

A

CLL

228
Q

Wire loop glomerular capillary on LM

A

Lupus nephropathy

229
Q

Yellowish CSF

A

Xanthochromia (2/2 SAH)

Step 1 Prep (15 decks)

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