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Step 1 - Quick Decks > Lab Findings (Rapid Review) > Flashcards

Lab Findings (Rapid Review) Flashcards

1
Q

Colonies of Pseudomonas in lungs

A

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

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2
Q

Decreased AFP in amniotic fluid/maternal serum

A

Down syndrome, Edwards syndrome

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3
Q

Increased beta-hCG, decreased PAPP-A on first trimester screening

A

Down syndrome

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4
Q

Increased serum homocysteine, increased methylmalonic acid, decreased folate

A

Vitamin B12 deficiency

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5
Q

Anti-histone antibodies

A

Drug-induced SLE

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6
Q

Decreased T cells, decreased PTH, decreased Ca2+, absent thymic shadow on CXR

A

Thymic aplasia (DiGeorge syndrome, velocardiofacial syndrome)

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7
Q

Recurrent infections, eczema, thrombocytopenia

A

Wiskott-Aldrich syndrome

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8
Q

Large granules in phagocytes, immunodeficiency

A

Chediak-Higashi disease (congenital failure of Phagolysosome formation)

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9
Q

Optochin sensitivity

A

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

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10
Q

Novobiocin response

A

Sensitive: S epidermidis; resistant: S saprophyticus

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11
Q

Bacitracin response

A

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

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12
Q

Branching gram (+) rods with sulfur granules

A

Actinomyces israelii

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13
Q

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

A

Ghon complex (1 deg TB: Myocobacterium bacilli)

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14
Q

“Thumb sign” on lateral neck x-ray

A

Epiglottitis (Haemophilus influenzae)

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15
Q

Bacteria-covered vaginal epithelial cells

A

“Clue cells” (Gardnerella vaginalis)

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16
Q

Dilated cardiomyopathy with apical atrophy, megacolon, megaesophagus

A

Chagas disease (Trypanosoma cruzi)

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17
Q

Atypical lymphocytes, heterophile antibodies

A

Infectious mononucleosis (EBV infection)

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18
Q

Narrowing of upper trachea and subglottis (Steeple sign) on x-ray

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

Toxoplasma gondii (multiple), CNS lymphoma (may be solitary)

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21
Q

Psammoma bodies

A

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

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22
Q

“Boot-shaped” heart on x-ray

A

Tetralogy of Fallot (due to RVH)

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23
Q

Rib notching (inferior surface, on x-ray)

A

Coarctation of the aorta

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24
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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25
Q

Electrical alternans (alternating amplitude on ECG)

A

Cardiac tamponade

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26
Q

Granuloma with giant cells after pharyngeal infection

A

Aschoff bodies (rheumatic fever)

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27
Q

Empty-appearing nuclei with central clearing of thyroid cells

A

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

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28
Q

“Brown” tumor of bone

A

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

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29
Q

Hypertension, hypokalemia, metabolic alkalosis

A

Primary hyperaldosteronism (eg, Conn syndrome)

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30
Q

Mucin-filled cell with peripheral nucleus

A

“Signet ring” cells (diffuse 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 accumulations in liver cell vacuoles

A

Fatty liver disease (alcoholic or metabolic syndrome)

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38
Q

Anti-smooth muscle antibodies (ASMAs), anti-liver/kidney microsomal-1 (anti-LKM1) antibodies

A

Autoimmune hepatitis

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39
Q

“Nutmeg” appearance of liver

A

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

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40
Q

Animitochondrial antibodies (AMAs)

A

Primary biliary cholangitis (female, cholestatis, portal hypertension)

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41
Q

Low serum ceruloplasmin

A

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

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42
Q

Migratory thrombophlebitis (leading to migrating DVTs and vasculitis)

A

Trousseau syndrome (adenocarcinoma of pancreas)

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43
Q

Hypersegemented neutrophils

A

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

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44
Q

Basophilic nuclear remnants in RBCs

A

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

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45
Q

Basophilic stippling of RBCs

A

Lead poisoning or sideroblastic anemia

46
Q

Hypochromic, microcytic anemia

A

Iron deficiency anemia, lead poisoning, thalssemia (fetal hemglobin sometimes present)

47
Q

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

A

Beta-thalassemia, sickle cell disease (marrow expansion)

48
Q

Anti-GpIIb/IIIa antibodies

A

Immune thrombocytopenia

49
Q

High level of D-dimers

50
Q

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

A

Reed-Sternberg cells (Hodgkin lymphoma)

51
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” make up of malignant cells)

52
Q

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

A

Multiple myeloma

53
Q

Monoclonal spike on serum protein electrophoresis

A

Myltiple myeloma (usually IgG or IgA), Waldenstrom macroglobulinemia (IgM), Monoclonal gammopathy of undetermined significance

54
Q

Stacks of RBCs

A

Rouleaux formation (high ESR, multiple myeloma

55
Q

Azurophilic peroxidase (+) granular inclusions in granulocytes and myeloblasts

A

Auer rods (APL)

56
Q

WBCs that look “smudged”

57
Q

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

A

Birbeck granules (Langerhans cell histiocytosis)

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)

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

Increased uric acid levels

A

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

65
Q

“Bamboo spine” on x-ray

A

Ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27)

66
Q

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

A

SLE (type III hypersensitivity)

67
Q

Antineutrophil cytoplasmic antibodies (ANCAs)

A

Microscopic polyangiitis, eosinophilic granulomatosis with polyangiitis, and primary sclerosing cholangitis (MPO-ANCA/p-ANCA); granulomatosis with polyangiitis (PR3-ANCA/c-ANCA)

68
Q

Anticentromere antibodies

A

Limited scleroderma (CREST syndrome)

69
Q

Anti-topoisomerase antibodies

A

Diffuse scleroderma

70
Q

Anti-desmoglein (anti-desmosome) antibodies

A

Pemphigus vulgaris

71
Q

Antihemidesmosome antibodies

A

Bullous pemphigoid

72
Q

Keratin pearls on a skin biopsy

A

Squamous cell carcinoma

73
Q

Increased AFP in amniotic fluid/maternal serum

A

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

74
Q

Bloody or yellow tap on lumbar puncture

A

Xanthochromia (due to subarachnoid hemorrhage)

75
Q

Eosinophilic cytoplasmic inclusion in neuron

A

Lewy body (Parkinson disease and Lewy body dementia)

76
Q

Extracellular amyloid deposition in gray matter of brain

A

Senile plaques (Alzheimer disease)

77
Q

Depigmentation of neurons in substantia nigra

A

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

78
Q

Protein aggregates in neurons from hyperphosphorylation of tau protein

A

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

79
Q

Silver-staining spherical aggregation of tau proteins in neurons

A

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

80
Q

Pseudopalisading pleomorphic tumor cells on brain biopsy

A

Glioblastoma multiforme

81
Q

Small blue cells surrounding central area of neuropil

A

Homer-Wright rosettes (neuroblastoma, medulloblastoma)

82
Q

“Waxy” casts with very low urine flow

A

Chronic end-stage renal disease

83
Q

WBC casts in urine

A

Acute pyelonephritis, transplant rejection, tubulointerstitial inflammation

84
Q

RBC casts in urine

A

Glumerulonephritis

85
Q

Anti-glomerular basement membrane antibodies

A

Goodpasture syndrome (glomerulonephritis and hemoptysis)

86
Q

Cellular cresecents in Bowman capsure

A

Rapidly progressive (crescentic) glomerulonephritis

87
Q

“Wire loop” glomerular capillary appearance on light microscopy

A

Diffuse proliferative glomeruloephritis (usually seen with lupus)

88
Q

Linear appearance of IgG deposition on glomerular and alveolar basement membranes

A

Goodpasture syndrome

89
Q

“Lumpy bumpy” appearance of glomeruli on immunofluorescence

A

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

90
Q

Necrotizing vasulitis (lungs) and necrotizing glomerulonephritis

A

Granulomatosis with poly angiitis (PR3-ANCA/c-ANCA) and Goodpasture syndrome (anti-basement membrane antibodies)

91
Q

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

A

Membranoproliferative glomerulonephritis

92
Q

Nodular hyaline deposits in golmeruli

A

Kimmelstiel-Wilson nodules (diabetic nephropathy)

93
Q

Podocyte fusion or “effacement” on electron microscopy

A

Minimal change disease (child with nephrotic syndrome)

94
Q

“Spikes” on bassement membrane, “domelike” subepithelial deposits

A

Membranous nephropathy (nephrotic syndrome)

95
Q

Thyroidlike appearance of kidney

A

Chronic pyelonephritis (usually due to recurrent infections)

96
Q

Granular casts in urine

A

Acute tubular necrosis (eg, ischemia or toxic injury)

97
Q

hCG elevated

A

Multifetal gestation, hydatidiform moles, choriocarcinomas, Down syndrome

98
Q

Dysplastic squamous cervical cells with “raisinoid” nuclei and hyperchromasia

A

Koilocytes (HPV: predisposes to cervical cancer)

99
Q

Sheets of uniform “fried egg” cells, increased hCG, increased LDH

A

Dysgerminoma

100
Q

Glomeruluslike structure surrounding vessel in germ cells

A

Schiller-Duval bodies (yolk sac tumor)

101
Q

Disarrayed granulosa cells arranged around collections of eosinophilic fluid

A

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

102
Q

“Chocolate cyst” of ovary

A

Endometriosis (frequently involves both ovaries)

103
Q

Mammary gland (“blue domed”) cyst

A

Fibrocystic change of the breast

104
Q

Rectangular, crystal-like, cytoplasmic inclusion in Leydig cells

A

Reinke crystals (Leydig cell tumor)

105
Q

Thrombi made of white/red layers

A

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

106
Q

Hexagonal, double-pointed, needlelike crystals in bronchial secretions

A

Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)

107
Q

Desquamated epithelium casts in sputum

A

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

108
Q

“Honeycomb lung” on x-ray or CT

A

Idiopathic pulmonary fibrosis

109
Q

Iron-containing nodules in alveolar septum

A

Ferruginous bodies (asbestosis: increased chance of lung cancer)

110
Q

Bronchogenic apical lung tumor on imaging

A

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

Step 1 - Quick Decks (18 decks)

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