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USMLE Step 1. > First Aid Classic Labs/Findings > Flashcards

First Aid Classic Labs/Findings 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

RA (systemic inflammation, joint pannus, boutonniere 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 polyangiitis and eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome) (MPO-ANCA/pANCA); granulomatosis with polyangiitis (wegener; PR3-ANCA/cANCA)

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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

Antiplatelet antibodies

A

Idiopathic thrombocytopenic purpura

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10
Q

Anti-topoisomerase antibodies

A

Diffuse systemic scleroderma

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11
Q

Anti-transglutaminase/anti-endomysial antibodies

A

Celiac disease (diarrhea, weight loss)

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12
Q

“Apple core” lesion on 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 (+) 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: S.pyogenes (groupA); resistant: S.agalactiae (group B)

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16
Q

“Bamboo spine” on XR

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 XR

A

Tetralogy of Fallot (due to RVH)

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21
Q

Branching gram (+) rods with sulfur granules

A

Actinomyces israelii

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22
Q

Bronchogenic 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 fibrosa cystica (depositied 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 crescentic 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 mucoid Pseudomonas in lungs

A

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

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29
Q

Low AFP in amniotic fluid/maternal serum

A

Down syndrome or other chromosomal abnormality

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30
Q

Degeneration of dorsal column fibers

A

Tabes dorsalis (tertiary syphilis), subacute combined degeneration (dorsal columns, lateral corticospinal, spinocerebeller tracts affected)

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31
Q

“delta wave” on EKG, short PR interval, supraventricular tachcardia

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

Disarryed granulosa cells arranged around collections of eosinophilic fluid

A

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

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35
Q

Dysplastic squamous cervical cells with “raisinoid” nuclei and hyperchromasia

A

Koilocytes (HPV: predisposes to cervical cancer)

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36
Q

Electrical alternans (alternating amplitude in 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

Enlarged thyroid cells with ground-glass nuclei with central clearing

A

“Orphan Annie” eyes nuclei (papillary carcinoma of the thyroid)

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40
Q

Eosinophilic cytoplasmic inclusion in liver cell

A

Mallory body (alcoholic liver disease)

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41
Q

Eosinophilic cytoplasmic inclusion in nerve cell

A

Lewy body (parkinson disease)

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42
Q

Eosinophilic globule in liver

A

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

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43
Q

Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar neurons

A

Negri bodies of rabies

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44
Q

Extracellular amyloid deposition in gray matter of brain

A

Senile plaques (Alzheimer disease)

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45
Q

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

A

Reed-Sternberg cells (Hodgkin lymphoma)

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46
Q

Glomerulus-like structure surrounding vessel in germ cells

A

Schiller-Duval bodies (yolk sac tumor)

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47
Q

“Hair on end” (“Crew-cut”) appearance on XR

A

Beta-Thalassemia, sickle cell disease (marrow expansion)

48
Q

hCG elevated

A

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

49
Q

Heart nodules (granulomatous)

A

Aschoff bodies (rheumatic fever)

50
Q

Heterophile antibodies

A

Infectious mononucleosis (EBV)

51
Q

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

A

Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)

52
Q

High levels of D-Dimers

A

DVT, PE, DIC

53
Q

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

A

Ghon complex (primary TB: Mycobacterium bacilli)

54
Q

“Honeycomb sign” on XR or CT

A

Interstitial pulmonary fibrosis

55
Q

Hypercoagulability (leading to migrating DVTs and vasculitis)

A

Trousseau syndrome (adenocarcinoma of pancreas or lung)

56
Q

Hypersegmented neutrophils

A

Megaloblastic anemia (B12 deficiency: neurologic symptoms; folate deficiency: no neuro symptoms)

57
Q

HTN, hypokalemia, metabolic alkalosis

A

Conn syndrome (primary hyperaldosteronism)

58
Q

Hypochromic, microcytic anemia

A

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

59
Q

Increased AFP in amniotic fluid/maternal serum

A

Dating error, anencephaly, spina bifida (neural tube defects)

60
Q

Increased uric acid levels

A

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

61
Q

Intranuclear eosinophilic droplet-like bodies

A

Cowdry type A bodies (HSV or VZV)

62
Q

Iron-containing nodules in alveolar sputum

A

Ferruginous bodies (asbestos: higher chance of mesothelioma)

63
Q

Keratin pearls on a skin biopsy

A

Squamous cell carcinoma

64
Q

Large granules in phagocytes, immunodeficiency

A

Chediak-Higashi disease (congenital failure of phagolysosome formation)

65
Q

“Lead Pipe” appearance of colon on abdominal imaging

A

Ulcerative colitis (loss of haustra)

66
Q

Linear apperance of IgG deposition on glomerular and alveolar basement membranes

A

Goodpasture syndrome

67
Q

Low serum ceruloplasmin

A

Wilson disease (hepatolenticular degeneration

68
Q

Low serum ceruloplasmin

A

Wilson disease (hepatolenticular degeneration

69
Q

“Lumpy bumpy” appearance of glomeruli on immunofluorescence

A

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

70
Q

Lytic (“punched out”) bone lesions on XR

A

Multiple myeloma

71
Q

Mammary gland (“blue domed”) cyst

A

Fibrocystic change of the breast

72
Q

Monoclonal antibody spike

A

Multiple Myeloma (usually IgG or IgA)

Monoclonal gammapathy of undetermined significance (MGUS consequence of aging)

Walderstrom (M protein = IgM) macroglobulinemia

Primary amyloidosis

73
Q

Mucin-filled cell with peripheral nucleus

A

“Signet ring” (gastric carcinoma)

74
Q

Narrowing of bowel lumen on barium XR

A

“string sign” (Crohn disease)

75
Q

Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis

A

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

Goodpasture syndrome (anti-basement membrane antibodies)

76
Q

Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis

A

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

Goodpasture syndrome (anti-basement membrane antibodies)

77
Q

Needle shaped, negatively birefringent crystals

A

Gout (monosodium urate crystals)

78
Q

Nodular hyaline deposits in glomeruli

A

Kimmelstiel-Wilson nodules (diabetic nephropathy)

79
Q

Novobiocin response

A

Sensitive: S.epidermidis

Resistant: S. saprophyticus

80
Q

“Nutmeg” appearance of liver

A

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

81
Q

“Onion skin” appearance of liver

A

Ewing sarcoma (malignant small blue cell tumor)

82
Q

Optochin response

A

Sensitive: S. pneumoniae

Resistant: viridans streptococci - S. mutans, S. sanguis

83
Q

Periosteum raised from bone, creating triangular area

A

Codman triangle on XR, Ewing sarcoma, pyogenic osteomyelitis

84
Q

Podocyte fusion or “effacement” on electron microscopy

A

Minimal change disease (child with nephrotic syndrome)

85
Q

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

A

Eburnation (osteoarthritis resulting in bony sclerosis)

86
Q

Protein aggregates in neurons from hyperphosphorylation of tau protein

A

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

87
Q

Psammoma bodies

A

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

88
Q

Pseudopalisading tumor cells on brain biopsy

A

Glioblastoma multiforme

89
Q

RBC casts in urine

A

Glomerulonephritis

90
Q

Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells

A

Reinke crystals (Leydig cell tumor)

91
Q

Recurrent infections, eczema, thrombocytopenia

A

Wiskott-Aldrich syndrome

92
Q

Renal epithelial casts in urine

A

intrinsic renal failure (ischemia or toxic injury)

93
Q

Rhomboid crystals, positively birefringent

A

Pseudogout (calcium pyrophospate dihydrate crystals)

94
Q

Rib notching

A

Coarctation of the aorta

95
Q

Ring-enhancing brain lesion in AIDS

A

Toxoplasma gondii, CNS lymphoma

96
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)

97
Q

Silver-staining spherical aggregation of tau proteins in neurons

A

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

98
Q

“Soap bubble” on femur or tibia on XR

A

Giant cell tumor (generally benign)

99
Q

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

A

Membranous nephropathy (nephrotic syndrome)

100
Q

Stacks of RBCs

A

Rouleaux formation (high ESR, multiple myeloma)

101
Q

“Steeple sign” on CXR

A

Croup (parainfluenza virus)

102
Q

Stippled vaginal epithelial cells

A

“Clue cells” (Gardnerella vaginalis)

103
Q

Streptococcus bovis bacteremia

A

Colon cancer

104
Q

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

A

Birbeck granules (Langerhans cell histiocytosis)

105
Q

Thousands of polyps on colonoscopy

A

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

106
Q

Thrombi made of white/red layers

A

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

107
Q

“Thumb sign” on lateral neck XR

A

Epiglottitis (H. flu)

108
Q

Thyroid-like appearance of kidney

A

Chronic pyelonephritis (usually due to recurrent infections)

109
Q

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

A

Membranoproliferative glomerulonephritis

110
Q

Triglyceride accumulation in liver cell vacuoles

A

Fatty liver disease (alcoholic or metabolic syndrome)

111
Q

“Waxy” casts with very low urine flow

A

Chronic end-stage renal disease

112
Q

WBC casts in urine

A

Acute pyelonephritis

113
Q

WBCs that look “smudged”

A

CLL (almost always B cell)

114
Q

“Wire loop” glomerular capillary appearance on light microscopy

A

Diffuse proliferative glomerulonephritis (usually seen with lupus)

115
Q

Yellowish CSF

A

Xanthochromia (e.g. due to subarachnoid hemorrhage)

USMLE Step 1. (19 decks)

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