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Board questions > First Aid Classic Labs and Findings > Flashcards

First Aid Classic Labs and Findings Flashcards

1
Q

decreased AFP in amniotic fluid/maternal serum

A

Down syndrome or other chromosomal abnormalities

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2
Q

large granules in phagocytes, immunodeficiency

A

Chediak-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

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

A

ghon complex (primary TB)

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5
Q

bacteria-covered vaginal epithelial cells

A

“clue cells” (gardnerella vaginalis)

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6
Q

cardiomegaly with apical atrophy

A

Chagas disease (trypanosome cruzi)

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7
Q

intranuclear eosinophilic droplet-like bodies

A

Cowdry type A (HSV or VZV)

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8
Q

eosinophilic globule in liver

A

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

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9
Q

eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar neurons

A

Negri bodies of rabies

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10
Q

atypical lymphocytes

A

EBV

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11
Q

enlarged cells with intranuclear inclusion bodies

A

“owl eyes” appearance of CMV

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12
Q

“delta wave” on ECG, short PR interval, supra ventricular tachycardia

A

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

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13
Q

“boot shaped” heart on XR

A

tetralogy of Fallot (due to RVH)

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14
Q

rib notching (inferior surface on XR)

A

coarctication of the aorta

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15
Q

heart nodules (granulomatous)

A

Aschoff bodies (rheumatic fever)

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16
Q

electrical alternans (alternating amplitud on ECG)

A

pericardial tamponade

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17
Q

hypertension, hypokalemia, metabolic acidosis

A

primary hyperaldosteronism (Conn syndrome)

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18
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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19
Q

antineutrophil cytoplasmic antibodies (ANCAs)

A
  • Microscopic polyangiitis and eosinophilic granulomatosis with polyangiitis
    • MPO-ANCA/p-ANCA
  • granulomatosis with polyangiitis (Wegener)
    • PR3-ANCA/c-ANCA
  • primary sclerosing cholangitis
    • MPO-ANCA/p-ANCA
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20
Q

mucin-filled cell with peripheral nucleus

A

“signet ring” (gastric carcinoma)

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21
Q

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

A

celiac disease (diarrhea, weight loss)

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22
Q

narrowing of bowel lumen on barium XR

A

“string sign” (Crohn disease)

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23
Q

“lead pipe” appearance of colon on abdominal imaging

A

ulcerative colitis (loss of haustra)

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24
Q

thousands of polyps on colonoscopy

A

Familial adenomatous polyposis (AD, mutation of APC gene)

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25
Q

“apple core” lesion on barium enema XR

A

colorectal cancer (usually L sided)

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26
Q

eosinophilic cytoplasmic inclusion in liver cell

A

Mallory body (alcoholic liver disease)

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27
Q

triglyceride accumulation in liver cell vacuoles

A

fatty liver disease (alcoholic or metabolic syndrome)

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28
Q

“nutmeg” appearance of liver

A

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

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29
Q

Antimitochondrial antibodies (AMAs)

A

Primary biliary cirrhosis (female, cholestasis, portal hypertension)

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30
Q

low serum ceruloplasmin

A

Wilson disease

hepatolenticular degeneration; Kayser-Fleischer rings due to copper accumulation

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31
Q

migratory thrombophlebitis (leading to migrating DVTs and vasculitis)

A

Trousseau syndrome

adenocarcinoma of pancreas or lung

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32
Q

basophilic nuclear remnants in RBCs

A

Howell-Jolly bodies

due to splenectomy or nonfunctional spleen

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33
Q

hypochromic, microcytic anemia

A

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

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34
Q

basophilic stippling of RBCs

A

lead poisoning or sideroblastic anemia

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35
Q

“hair on end” (“crew cut”) appearance on XR

A

Beta-thalassemia, sickle cell disease (marrow expansion)

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36
Q

hypersegmented neutrophils

A

megaloblastic anemia

  • B12 deficiency
    • neurologic symptoms
  • folate deficiency
    • no neuro ssx
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37
Q

antiplatelet antibodies

A

idiopathic thrombocytopenic purpura

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38
Q

Giant B cells with bilobed nuclei with prominent inclusions (“owl eyes”)

A

Reed-Sternberg cells

Hodgkins lymphoma

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39
Q

Sheets of medium-sized lymphoid cells with scattered pale, tingible body-laden macrophages

A
  • Burkitt lymphoma
    • t(8:14)
    • c-myc activation
    • a/w EBV
    • “starry sky” histology made of malignant cells
40
Q

lytic “punched out” bone lesions on XR

A

multiple myeloma

41
Q

monoclonal antibody spike

ddx?

A
  • multiple myeloma (usually IgG or IgA)
  • monoclonal gammopathy of undetermined significance (MGUS consequence of aging)
  • Waldenstrom (M protein = IgM) macroglobulinemia
  • Primary amyloidosis
42
Q

stacks of RBCs

A

Rouleaux formation (high ESR, multiple myeloma)

43
Q

azurophilic peroxidase positive granular inclusions in granulocytes and myeloblasts

A

auer rods (AML, especially the promyelocytic M3 type)

44
Q

WBCs that look ‘smudged’

A

CLL (almost always B cell)

45
Q

“tennis-raquet”-shaped cytoplasmic organelles (EM) in Langerhans cells

A

Birbeck granules (Langerhans cell histiocytosis)

46
Q

“Brown” tumor of bone

A

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

47
Q

raised periosteum (creating a ‘Codman triangle’)

A

aggressive bone lesion (osteosarcoma, Ewing sarcoma, osteomyelitis)

48
Q

“soap bubble” in femur or tibia on XR

A

giant cell tumor of bone (generally benign)

49
Q

“onion skin” periosteal reaction

A

Ewing sarcoma (malignant small blue cell tumor)

50
Q

Anti-IgG antibodies

A

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

51
Q

Rhomboid crystals, positive birefringent

A

pseudogout (calcium pyrophosphate dihydrate crystals)

52
Q

needle shaped, negative birefringent crystals

A

gout (monosodium urate crystals)

53
Q

increased uric acid levels ddx

A
  • gout
  • Lesch-Nyhan syndrome
  • tumor lysis syndrome
  • loop and thiazide diuretics
54
Q

“bamboo spine” on XR

A

ankylosing spondylosis (chronic inflammatory arthritis; HLA:B27)

55
Q

antinuclear antibodies (ANAs: anti-Smith and anti-dsDNA)

A

SLE (type III hypersensitivity)

56
Q

anti-topoisomerase antibodies

A

diffuse systemic scleroderma

57
Q

antihistone antibodies

A

drug-induced SLE (eg, hydralazine, isoniazid, phenytoin, procainamide)

58
Q

bloody or yellow tap on LP

A

subarachnoid hemorrhage

59
Q

yellowish CSF

A

xanthochromia (eg, due to subarachnoid hemorrhage)

60
Q

eosinophilic cytoplasmic inclusion in neuron

A

Lewy body (PD and lewy body dementia)

61
Q

extracellular amyloid deposition in gray matter of brain

A

senile plaques (AD)

62
Q

protein aggregates in neurons from hyperphosphorylation of tau protein

A

neurofibrillary tangles (AD) and Pick bodies (Pick disease)

63
Q

silver-staining spherical aggregation of tau proteins in neurons

A

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

64
Q

pseudopalisading tumor cells on brain biopsy

A

glioblastoma multiforme

65
Q

circular grouping of dark tumor cells surrounding pale neurofibrils

A

Homer-Wright rosettes (neuroblastoma, medulloblastoma)

66
Q

“waxy” casts with very low urine flow

A

chronic end stage renal disease

67
Q

RBC casts in urine

A

glomerulonephritis

68
Q

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

A

membranoproliferative glomerulonephritis

69
Q

nodular hyaline deposits in glomeruli

A

Kimmelstiel-Wilson nodules (diabetic nephropathy)

70
Q

podocyte fusion or “effacement” on electron microscopy

A

minimal change disease (child with nephrotic syndrome)

71
Q

“spikes” on basement membrane, “dome-like” subepithelial deposits

A

membranous nephropathy (nephrotic syndrome)

72
Q

anti-glomerular basement membrane antibodies

A

Goodpasture syndrome (glomerulonephritis and hemoptysis)

73
Q

cellular crescents in Bowman capsule

A

rapidly progressive crescenteric glomerulonephritis

74
Q

“wire loop” glomerular capillary appearance on light microscopy

A

diffuse proliferative glomerulonephritis (usually seen with lupus)

75
Q

linear appearance of IgG depositon on glomerular and alveolar basement membranes

A

Goodpasture syndrome

76
Q

“lumpy bumpy” appearance of glomeruli on immunofluorescence

A

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

77
Q

necrotizing vasculitis (lungs) and necrotizing glomerulonephritis

A

granulomatosis with polyangiitis (Wegener; PR3-ANCA/c-ANCA)

and

Goodpasture syndrome (anti-basement membrane antibodies)

78
Q

thyroid-like appearance of kidney

A

chronic pyelonephritis (usually due to recurrent infections)

79
Q

WBC casts in urine

A

acute pyelonephritis

80
Q

renal epithelial casts in urine

A

intrinsic renal failure (eg, ischemia or toxic injury)

81
Q

hCG elevated ddx

A

choriocarcinoma

hydatiform mole (occurs with and without embryo, and multiple pregnancy)

82
Q

dysplastic squamous cervical cells with “raisinoid” nuclei and hyperchromasia

A

koilocytes (HPV: predisposes to cervical cancer)

83
Q

psammoma bodies ddx

A
  • meningiomas
  • papillary thyroid carcinoma
  • mesothelioma
  • papillary serous carcinoma of the endometrium and ovary
84
Q

disarrayed granulosa cells arranged around collections of eosinophilic fluid

A

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

85
Q

“chocolate cyst” of ovary

A

endometriosis (frequently involves both ovaries)

86
Q

mammary gland (“blue domed”) cyst

A

fibrocystic change of the breast

87
Q

glomerulus-like structure surrounding vessel in germ cells

A

Schiller-Duval bodies (yolk sac tumor)

88
Q

rectangular, crystal-like, cytoplasmic inclusions in Leydig cells

A

Reinke crystals (Leydig cell tumor)

89
Q

thrombi made of white/red layers

A

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

90
Q

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

A

bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)

91
Q

desquamated epithelium casts in sputum

A

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

92
Q

“honeycomb lung” on XR or CT

A

interstitial pulmonary fibrosis

93
Q

colonies of mucoid Pseudomonas in lungs

A

cystic fibrosis - autosomal recessive mutation of CFTR gene (fat soluble vitamin deficiency and mucous plugs)

94
Q

iron-containing nodules in alveolar septum

A

ferruginous bodies (asbestosis: increase chance of lung cancer)

95
Q

bronchogenic apical lung tumor on imaging

A

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

Board questions (24 decks)

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