Classic presentations/labs/path findings 1st aid Flashcards

1
Q

Abdominal pain, ascites, hepatomegaly

A

Budd-Chiari Syndrome-occlusion of IVC/hepatic veins

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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-Fredrichsen Syndrome (neisseria meningiditis)

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4
Q

Arachnodactyly, lens discoloration, aortic dissection, hyperflexible joints

A

Marfan Syndrome (fibrillin defect)

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5
Q

Back pain, fever, night sweats, weight loss

A

Pott’s Disease (TB)

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6
Q

Bilateral hilar adenopathy, uveitis, noncaseating granulomas

A

Sarcoidosis

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7
Q

Blue sclera

A

osteogenesis imperfecta (type 1 collagen)

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8
Q

Blue line on gingiva

A

Burton’s line-lead poisoning

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9
Q

Bone pain, bone enlargement, arthritis, chalkstick fractures

A

Pagets Disease of bone

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10
Q

Bounding pulses, diastolic heart murmur, head bobbing

A

Aortic regurgitation

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11
Q

Butterfly facial rash, Raynaud’s in female

A

SLE

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12
Q

Cafe au lait spots, Lisch nodules (iris hamartoma)

A

NF type 1

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13
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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14
Q

Calf pseudohypertrophy

A

duchenne muscular dystrophy-X linked recessive mutation of dystrophin

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15
Q

Cherry red spot on macula

A

Neimann Pick (sphingomyelin accumulation) or Tay Sachs (ganglioside accumulation) or central retinal artery occlusion

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16
Q

chest pain, pericardial effusion/friction rub, persistent fever following an MI

A

Dressler syndrome (autoimmune post-MI fibrinous pericarditis)

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17
Q

Child used arms to stand up from squat

A

Gower sign-DMD

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18
Q

Child with fever, develops red rash on face

A

Slap cheek fever- Parvovirus B19 (erythema infectiosum, 5th disease)

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19
Q

Chorea, dementia, caudate degeneration

A

Huntington Disease- CAG repeats

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20
Q

Exercise intolerance with myalgia, fatigue, painful cramps and myoglobinuria

A

McArdle’s Disease (muscle glycogen phosphorylase deficiency)

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21
Q

Conjugate lateral gaze palsy, horizontal diplopia

A

internuclear ophthalmoplegia (damage to MLF) bilateral= MS, unilateral=stroke

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22
Q

continuous machinery murmur

A

PDA-can close with indomethacin, keep open with misopristol

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23
Q

cutaneous dermal edema due to connective tissue deposition

A

myxedema

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24
Q

Dark purple skin/mouth nodules

A

Kaposi Sarcoma HHV8

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25
Q

Deep, labored breathing/hyperventilation

A

Kussamaul breathing-DKA

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26
Q

Dermatitis, Dementia, Diarrhea, Death

A

Pellagra: Niacin (B3) deficiency

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27
Q

dilated cardiomyopathy, edema, alcoholism, malnutrition

A

Wet Beriberi: thiamine (B1) deficiency

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28
Q

dry eyes, dry mouth, arthritis

A

Sjrogrens syndrome-destruction of exocrine glands

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29
Q

Dysphagia (esophageal webs), glossitis (beefy red tongue) and iron deficiency anemia

A

Plummer Vinson syndrome

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30
Q

Elastic skin, joint hypermobility

A

Ehlers-Danlos (type III collagen defect)

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31
Q

Enlarged, hard left supraclavicular node

A

Virchows node- abdominal metastasis

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32
Q

Erythroderma, lymphadenopathy, hepatosplenomegaly, atypical T cells (cerebriform nuclei and Pautrier microabcesses)

A

Sezary syndrome/Mycosis fungoides

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33
Q

facial muscle spasm upon tapping nerve

A

Chovsteks sign: indicates hypocalcemia

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34
Q

fever, chills, headache, myalgia following abx treatment for syphillis

A

Jarisch-Herxheimer reaction: rapid lysis of spirochetes resulting in toxin release)

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35
Q

fever, cough, conjunctivitis, choryza, rash

A

Measles (paramyxovirus)

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36
Q

fibrous plaques in soft tissue of penis

A

Peyronie’s Disease (connective tissue disorder)

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37
Q

gout, mental retardation, self mutilation behavior in young boy

A

Lesch Nyhan syndrome: HGPRT deficiency

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38
Q

Hamartomatous GI polyps, hyperpigmentation of the mouth, feet and hands

A

Peutz-Jeuger syndrome, increased risk of colon CA

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39
Q

Hepatosplenomegaly, osteoporosis, neurologic symptoms

A

Gaucher disease (glucocerebrosidase deficiency

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40
Q

Hereditary nephritis, sensineuronal hearing loss, cataracts

A

Alport syndrome (mutation in alpha chain of collagen IV)

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41
Q

Hyperphagia, hypersexuality, hyperorality, docile

A

Kluver Bucy syndrome-bilateral amygdala lesion

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42
Q

Hyporeflexia, atrophy, hypotonia, fasiculations

A

LMN injury

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43
Q

Hypoxemia, polycythemia, hypercapnia

A

chronic bronchitis, “Blue bloater” hyperplasia of mucus cells

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44
Q

infant with cleft lip/palate, microcephaly or holoprocencephaly, polydactyly, cutis aplasia

A

Patau syndrome: trisomy 13

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45
Q

infant with failure to thrive, hepatosplenomagaly, neurodegeneration

A

Neimann-Pick (sphingomyleinase deficiency)

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46
Q

Infant with hypoglycemia, failure to thrive, hepatomegaly

A

Cori’s disease (debranching enzyme deficiency)

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47
Q

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

A

Edwards syndrome (trisomy 18)

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48
Q

jaundice, palpable distended GB

A

Courvoisiers sign (distal obstruction of biliary tree)

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49
Q

lucid interval after traumatic head injury

A

Epidural hematoma (MMA rupture)

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50
Q

Boy, recurrent infections, no mature B cells

A

Bruton’s X linked agammaglobulinemia)

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51
Q

mucosal bleeding and prolonged bleeding time

A

Glanzmann’s thrombasthenia (lack of Gp IIb/IIIa)

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52
Q

muffled heart sounds, JVD, hypotension

A

Beck’s triad for cardiac tamponade

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53
Q

multiple colon polyps, osteomas, impacted teeth

A

Gardener’s syndrome (type of familial adenomatous polyposis)

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54
Q

myopathy, infantile hypertrophic cardiomyopathy, exercise intolerance

A

Pompe disease (lysosomal alpha 1,4 glucosidase deficiency)

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55
Q

nystagmus, intention tremor, scanning speech, bilateral internuclear ophthalmoplegia

A

MS

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56
Q

oscillating slow/fast breathing

A

Cheyenne-stokes (central apnea in CHF or increased ICP)

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57
Q

painful blue digits, hemolytic anemia

A

cold agglutinin disease (autoimmune hemolytic anemia caused by mycolpasma pneumo and infectious mononucleosis)

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58
Q

painful red, raised lesions on pads of fingers and toes

A

Osler’s nodes (infective endocarditis)

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59
Q

painless erythematous lesions on palms and soles

A

Janeway lesions (infective endocarditis, septic emboli)

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60
Q

palpable purpura on buttocks/legs, joint pain, abdominal pain, hematuria in a child

A

Henoch Schonlen purpura usually following viral illness

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61
Q

pancreatic, pituitary and parathyroid tumor

A

MEN 1

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62
Q

periorbital, peripheral edema, proteinuria, hypoalbuminemia, hypercholesterolemia

A

nephrotic syndrome

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63
Q

pink complexion, dyspnea, hyperventilation

A

emphysema “pink puffer”
centriacinar=smoking
panacinar=alpha 1 AT deficiency

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64
Q

polyuria, renal tubular acidosis type 2, growth failure, electrolyte imbalances, hypophosphatemic rickets

A

Fanconi’s syndrome (proximal tubular reabsorbtion defect)

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65
Q

pruritic, purple, polygonal planar papules and plaques (6 p’s)

A

Lichen planus

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66
Q

ptosis, miosis, anhidrosis

A

Horner’s syndrome (sympathetic chain lesion)

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67
Q

pupil accommodates but does not react

A

Argyll Robertson pupil (neurosyphillis)

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68
Q

rapidly progressive leg weakness that ascends following GI/URI infection

A

Guillian Barre syndrome-acute autoimmune inflammatory demyelinating peripheral neuropathy

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69
Q

ddx for rash on palms and soles

A

Coxsackie A, Secondary syphillis, RMSF

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70
Q

recurrent colds, unusual eczema, high serum IgE

A

Job syndrome: hyper IgE, neutrophil chemotaxis abnormality

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71
Q

currant jelly sputum in alcoholic or diabetic pts

A

Kleb pnuemo

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72
Q

currant jelly stools

A

Intussusception in kids or acute mesenteric ischemia in adults

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73
Q

red urine in the morning, fragile RBC’s

A

Paroxysmal nocturnal hempglobinuria

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74
Q

Renal cell carcinoma, hemangioblastomas, angiomatosis, pheochromocytoma

A

Von Hippel Lindau disease (tumor suppressor gene mutation)

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75
Q

resting tremor, rigidity, akinesia, postural instability

A

Parkinson’s Disease (nigrostriatal dopamine depletion)

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76
Q

retinal hemorrhages with pale centers

A

Roth’s spots (bacterial endocarditis)

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77
Q

short stature, increased incidence of tumors and leukemia, aplastic anemia

A

Fanconi’s anemia (loss of DNA crosslink repair, progresses to AML)

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78
Q

situs inversus, chronic sinusitis, bronchiectasis, infertility

A

Kartagener’s syndrome (dyenin arm defect in cilia)

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79
Q

skin hyperpigmentation, hypotension, fatigue

A

Addison’s Disease (primary adrenocortical insufficiency)

80
Q

small, irregular red spots on buccal mucosa with blue/white centers

A

Koplik spots (measles, sometimes rubeola)

81
Q

splinter hemorrhages in nails

A

bacterial endocarditis

82
Q

streak ovaries, congenital heart disease, horseshoe kidney, short, webbed neck, lymphedema

A

Turner Syndrome (45 XO)

83
Q

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

A

Scurvy (vit C deficiency) can’t hydroxylate proline/lysine for collagen synthesis

84
Q

systolic ejection murmur (crescendo-decrescendo)

A

aortic valve stenosis

85
Q

Thyroid and parathyroid tumors, pheochromocytoma

A

MEN2A

86
Q

Thyroid tumor, pheochromocytoma, ganglioneuromatosis

A

MEN2B

87
Q

unilateral facial droop involving forehead

A

Facial nerve palsy (LMN)

88
Q

urethritis, conjunctivitis, arthritis in males

A

Reiter’s syndrome; reactive arthritis HLA-B27

89
Q

weight loss, diarrhea, arthritis, fever, adenopathy

A

Whipple disease (tropheryma whipplei)

90
Q

“worst headache of my life”

A

subarachnoid hemorrhage (berry aneurysm)

91
Q

Anti-centromere antibodies

A

Scleroderma

92
Q

Anti-glomerular basement membrane antibodies

A

Goodpasture’s syndrome (glomerulonephritis and hemoptysis)

93
Q

Anti-histone antibodies

A

Drug induced SLE (hydralazine, procainamide, isoniazid, phenytoin)

94
Q

Anti-IgG antibodies

A

Rheumatoid Arthritis

95
Q

Anti-mitochondrial antibodies

A

Primary biliary cirrhosis

96
Q

Anti-neutrophil cytoplasmic antibodies (ANCA)

A

Vasculitis (c-ANCA=granulomatosis with polyangitis-Wegener’s) (p-ANCA=microscopic polyangitis-Churg Strauss)

97
Q

Antinuclear antibodies (anti-smith and anti-dsDNA)

A

SLE

98
Q

antiplatelet antibodies

A

Idiopathic thrombocytopenic purpura

99
Q

Anti-topoisomerase antibodies

A

Diffuse systemic scleroderma

100
Q

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

A

Celiac disease

101
Q

Apple core lesion on abdominal x-ray

A

colorectal cancer (left sided)

102
Q

azurophilic peroxidase positive granular inclusions in granulocytes and myeloblasts

A

Auer rods (AML)

103
Q

Bacitracin response

A

Sensitive: strep pyogenes
Resistant: strep agalactiae

104
Q

Bamboo spine on x-ray

A

ankylosing spondylitis (HLA-B27)

105
Q

Calcineurin inhibitor, prevents production of IL2, Tx to suppress organ transplant rejection. SE: nephrotoxcity, gingival hyperplasia, peripheral neuropathy, HTN, hyperlipidemia, hyperglycemia, tremor, hirsuitism

A

Cyclosporine

106
Q

Calcineurin inhibitor binds to FK binding protein inhibiting secretion of IL2. Used in organ transplant recipients.SE: peripheral neuropathy, nephrotoxic, NO gingival hyperplasia and hirsuitism

A

Tacrolimus

107
Q

Precursor of 6-MP, toxic to proliferating lymphocytes. Used in kidney transplantation and autoimmune disorders. SE: BM suppression and drug interaction with Allopurinol.

A

Azathioprine

108
Q

monoclonal antibody: Antiplatelet agent, inhibits glycoprotein IIb/IIIa

A

Abciximab

109
Q

monoclonal antibody: targets CD20 and used in regiment for non-hodgkins lymphoma.

A

Rituximab

110
Q

monoclonal antibody: used in Crohn’s disease, RA, psoriatic arthritis and ankylosing spondylitis. Targets TNF alpha

A

Infliximab

111
Q

X linked defect in B cell maturation; recurrent bacterial infections, low B cell count and decreased immunoglobulins of all classes.

A

Bruton’s X linked agammaglobulinemia

112
Q

22q11 deletion, tetany, recurrent viral/fungal infections, congenital heart defects

A

DiGeorge syndrome (thymic aplasia)

113
Q

Defective IL2 receptor, failure to thrive, chronic diarrhea, thrush, recurrent infections of any kind, absence of thymic shadow, B cells and germinal centers

A

SCID

114
Q

Triad in Wiskott Aldrich syndrome

A

Thrombocytopenic purpura, Infections, Ezcema

115
Q

Defect in lysosomal trafficking regulation, recurrent pyogenic infections, partial albinism and peripheral neuropathy

A

Chediak Higashi syndrome

116
Q

lack of NADPH oxidase, absent respiratory burst in neutrophils, susceptability to catalase + bacteria like staph, Ecoli and aspergillus

A

Chronic granulomatous disease

117
Q

5 type III HS reactions

A

SLE, Poststrep glomerulonephritis, serum sickness, arthrus reaction, polyarteritis nodosa

118
Q

5 type IV HS reactions

A

PPD, GVHD, contact dermatitis, MS, Guillian Barre

119
Q

major chemotactic factor for neutrophils

A

IL-8

120
Q

stimulates growth of helper, cytotoxic and regulatory T cells

A

IL-2

121
Q

function of C3b

A

opsonization

122
Q

functions of C5b-C9

A

Membrane attack complex (deficiency=neisseria)

123
Q

produced in primary response to antigen, fixes complement, does NOT cross placenta.

A

IgM

124
Q

prevents attachments of bacteria and viruses to mucus membranes. monomer in circulation but dimer when secreted. found in secretions like tears, saliva and breastmilk

A

IgA

125
Q

delayed response to antigen, fixes complement and can cross the placenta (provides infnt with passive immunity), opsonizes bacteria and neutralizes toxins and viruses

A

IgG

126
Q

Psoriasis, ankylosing spondylitis, Reiter’s syndrome, IBD are associated with…

A

HLA-B27

127
Q

Celiac disease is associated with HLA-

A

DQ2 and DQ8

128
Q

MS, SLE and Goodpastures disease are assoc with HLA-

A

DR2

129
Q

DM type 1 and Grave’s disease are associated with HLA-

A

DR3

130
Q

Rheumatoid arthritis and DM type 1 are assoc with HLA-

A

DR4

131
Q

Pernicious anemia and Hashimotos thyroiditis

A

DR5

132
Q

Basophilic nuclear remnants in RBC’s

A

Howell Jolly bodies (sickle cell, asplenics, naphthalene, hereditary spherocytosis)

133
Q

Basophilic stippling of RBC’s

A

lead poisoning or sideroblastic anemia

134
Q

blood in a LP can indicate

A

subarachnoid hemorrhage

135
Q

branching Gram positive rods with sulfur granules

A

Actinomyces israeli

136
Q

Brown tumor of bone

A

Hyperparathyroidism which can cause osteitis fibrosis cystica (brown is from hemosiderin)

137
Q

cardiomegaly with apical atrophy can be from this infection

A

Chagas disease: T. cruzi

138
Q

cellular crescents in Bowman’s capsule

A

rapidly progressive crescenteric glomerulonephritis

139
Q

“chocolate cyst” of ovary

A

endometriosis

140
Q

circular grouping of dark tumor cells surrounding pale neurofibrils

A

Homer Wright rosettes (neuroblastoma, medulloblastoma, retinoblastoma)

141
Q

decreased alpha-fetoprotein in amniotic fluid

A

Down Syndrome or chromosomal abnormailty

142
Q

Degeneration of dorsal column nerves

A

Tabes doraslis (tertiary syphillis)

143
Q

Desquamated epithelium casts in sputum

A

Curschmann’s spirals (bronchial asthma)

144
Q

Enlarged thyroid cells with ground-glass nuclei

A

Orphan Annie’s eyes (papillary carcinoma)

145
Q

eosinophilic cytoplasmic inclusion in liver cell

A

mallory bodies (alcohol liver disease)

146
Q

eosinophilic cytoplasmic inclusion in nerve cell

A

Lewy body

147
Q

eosinophilic globule in liver

A

Councilman body (toxic or viral hepatitis, yellow fever)

148
Q

eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells

A

Negri bodies of Rabies

149
Q

Giant B cells with bilobed nuclei with prominent “owls eye inclusions”

A

Reed-Sternburg cells; CD30, Hodgkin Lymphoma

150
Q

crew-cut appearance on x-ray

A

Beta thalassemia, sickle cell

151
Q

heterophile antibodies are found in

A

infectious mononucleosis (EBV only)

152
Q

Hexagonal, needle like crystals in bronchial secretions

A

Charcot Leyden crystals found in bronchial asthma

153
Q

high level of D-dimers indicates

A

DVT, PE, DIC

154
Q

Hilar lymphadenopathy, peripheral granulomatous lesionmin middle or lower lung lobes which can calcify

A

Ghon complex (primary TB)

155
Q

Honeycomb lung on X-ray or CT

A

interstitial pulmonary fibrosis

156
Q

Hypercoagulability, leading to migratory DVT’s and vasculitis

A

Trosseau’s syndrome (adenocarcinoma of pancreas or lung)

157
Q

hypersegmented neutrophils are found in

A

Megaloblastic anemia

158
Q

Hypertension, hypokalemia, metabolic alkalosis indicate…

A

Conn’s syndrome

159
Q

Hypochromic, microcytic anemia

A

Iron deficiency anemia, lead poisoning, thalassemia

160
Q

increased alpha fetoprotein in the amniotic fluid can indicate

A

dating error, anencephaly, spina bifida or other neural tube defects

161
Q

Increased uric acid levels are found in

A

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

162
Q

Iron containing nodules in the alveolar septum

A

Ferruginous bodies (asbestosis)

163
Q

keratin pearls on a skin biopsy indicate

A

squamous cell carcinoma

164
Q

Large lysosomal vesicles in phagocytes, immunodeficiency

A

Chediak-Higashi disease (failure of phagolysosome fusion)

165
Q

Lead-pipe appearance of colon on barium x-ray

A

Ulcerative colitis

166
Q

Linear appearance of IgG deposition on glomerular basement membrane is a diagnostic finding of

A

Goodpasture’s Disease

167
Q

Low serum ceruloplasmin is a lab finding of

A

Wilson’s Disease

168
Q

“lumpy bumpy” appearance of glomeruli on immunoflorescence

A

Poststreptococcal glomerulonephritis (complex deposition of IgG and C3b)

169
Q

Lytic bone lesions on x-ray is characteristic of

A

multiple myeloma

170
Q

monoclonal antibody spikes can be found in these 4 conditions

A

multiple myeloma
monoclonal gammopathy of undetermined significance (MGUS)
Waldenstrom’s macroglobulinemia (IgM only)
Primary amyloidosis

171
Q

narrowing of bowel lumen on barium x-ray represents

A

“string sign” in Crohn’s disease

172
Q

Necrotizing vasculitis in lungs and necrotizing glomerulonephritis are found in

A

Granulomatosis with polyangitis (Wegener’s c-ANCA) and Goodpasture’s syndrome (anti-basement membrane ab’s)

173
Q

needle shaped, negatively birefringent crystals are found in

A

Gout

174
Q

nodular hyaline deposits in glomeruli

A

Kimmelsteil Wilson nodules (diabetic nephropathy)

175
Q

Classify bacteria based on novobiocin response

A

Sensitive: Staph epidermis
Resistant: Staph saprophyticus

176
Q

Nutmeg appearance of liver found in

A

Chronic passive congestion of liver due to right-sided heart failure

177
Q

“onion skin” periosteal reaction

A

Ewing’s sarcoma; malignant round cell tumor

178
Q

Classify bacteria based on Optochin response

A

Sensitive: Strep pneumo
Resistant: Viridians strep

179
Q

Periosteum raised from bone creating a triangular area on x-ray

A

Codman’s triangle: seen in Ewing sarcoma, osteosarcoma and pyogenic osteomyelitis

180
Q

Podocyte effacement or fusion on electron microscopy of glomerular basement membranse indicate

A

Minimal change disease (child with nephrotic syndrome)

181
Q

psammoma bodies are found in these 4 conditions

A

Meningiomas
papillary thyroid carcinoma
mesothelioma
papillary serous carcinoma of ovary/endometrium

182
Q

pseudopalisating tumor cells on brain biopsy are found in this type of cancer

A

glioblastoma multiforme

183
Q

RBC casts in urine are indicative of

A

acute glomerulonephritis

184
Q

rhomboid crystals, positively birefringent are found in

A

pseudogout

185
Q

rib notching on x-ray is a sign of

A

aortic coarctation

186
Q

Ring enhancing brain lesions are found in these 2 diseases:

A

Toxoplasma gondii and CNS lymphoma

187
Q

sheets of medium sized lymphoid cells with scattered pale macrophages on histology “starry sky”

A

Burkitt’s lymphoma; t8:14 which activated c-myc. Assoc with EBV

188
Q

Silver staining spherical aggregation of tau proteins in neurons

A

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

189
Q

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

A

Giant cell tumor of bone (generally benign)

190
Q

“spikes” on basement membrane of glomerulus and “dome like” subepithelial deposits

A

Membranous glomerulonephritis

191
Q

stippled vaginal epithelial cells, AKA “clue cells” are found in

A

Gardnerella vaginalis

192
Q

“tennis racket” shaped cytoplasmic organelles in Langerhans cells are found in

A

Langerhan histiocytosis (Birbeck granules)

193
Q

Thrombi made with white/red layers

A

Lines of Zahn (arterial thrombus) indicate flow

194
Q

“thumb sign” on lateral x-ray is indicative of

A

Epiglottititis (H. influenzae)

195
Q

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

A

Membranoproliferative glomerulonephritis

196
Q

“wire loop” glomerular capillary appearance on light microscopy

A

Lupus nephropathy