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USMLE Step 1 > Labs/Findings > Flashcards

Labs/Findings Flashcards

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USMLE® Step 1 flashcards
1
Q

anticentromere antibodies

A

scleroderma (CREST)

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2
Q

antidesmoglien (epithelial) antibodies

A

Pemphigus vulgaris (blistering)

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3
Q

anti-glomerular basement membrane antibodies

A

Goodpasture syndrome (glomerulonephritis & hemoptysis)

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4
Q

antihistone antibodies

A

drug-induced lupus (hydralazine, INH, phenytoin, procainamide)

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5
Q

anti-IgG antibodies

A

rheumatoid arthritis

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6
Q

antimitochondrial antibodies (AMA)

A

primary biliary cirrhosis (female, cholestasis, portal HTN)

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7
Q

antineutrophil cytoplasmic antibodies (ANCAs)

A

microscopic polyangiitis and Churg Strauss syndrome (pANCA); Wegener’s granulomatosis (cANDA)

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8
Q

antiplatelet antibodies

A

idiopathic thrombocytopenic purpura

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9
Q

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

A

SLE (type III hypersensitivity)

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10
Q

anti-topoisomerase antibodies

A

diffuse systemic scleroderma

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11
Q

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

A

celiac disease

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12
Q

“apple core” on abdominal xray

A

colorectal cancer (usually left-sided)

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13
Q

azurophilic peroxidase (+) granular inclusions in granulocytes and myeloblasts

A

Auer rods (AML, especially type M3)

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14
Q

bacitracin sensitive

A

Strep pyogenes (Group A strep)

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15
Q

bacitracin resistant

A

Strep agalactiae (group B)

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16
Q

bamboo spine on xray

A

ankylosing spondylitis

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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 tap on LP

A

subarachnoid hemorrhage

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20
Q

boot-shaped heart on xray

A

Tetralogy of Fallot, RVH

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21
Q

branching gram-positive rods with sulfur granules

A

Actinomyces israelii (israel has yellow sand granules)

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22
Q

bronchogenic apical lung tumor on imaging

A

Pancoast tumor (can compress sympathetic ganglion and cause Horner syndrome)

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23
Q

“Brown” tumor of bone

A

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

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24
Q

Cardiomegaly with apical atrophy

A

Chagas disease

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25
Q

cellular crescents in Bownman capsule

A

Rapidly progressive crescentic glomerulonephritis

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26
Q

“chocolate cyst” of ovary

A

endometriosis

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27
Q

circular grouping of dark tumor cells surrounding pale neurofibrils

A

Homer-Wright rosettes (neuroblastoma, medulloblastoma, retinoblastoma)

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28
Q

colonies of mucoid Pseudomonas in lungs

A

cystic fibrosis

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29
Q

decreased alpha-fetoprotein in amniotic fluid/maternal serum

A

Down syndrome or other chromosomal abnormality

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30
Q

degeneration of dorsal column nerves

A

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

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31
Q

depigmentation of neurons in substantia nigra

A

Parkinson disease

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32
Q

Desquamated epithelium casts in sputum

A

Curschmann spirals - bronchial asthma - can result in whorled mucous plugs

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33
Q

Disarrayed granulosa cells in eosinophilic fluid

A

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

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34
Q

dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia

A

koilocytes (HPV - predisposes to cervical cancer)

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35
Q

enlarged cells with intranuclear inclusion bodies

A

“owl eye” appearance of CMV

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36
Q

enlarged thyroid cells with ground-glass nuclei

A

“orphan annie” eyes nuclei (papillary carcinoma of the thyroid)

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37
Q

eosinophilic cytoplasmic inclusion in LIVER cell

A

Mallory body - alcoholic liver disease

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38
Q

eosinophilic cytoplasmic inclusion in NERVE cell

A

Lewy body - Parkinson disease

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39
Q

eosinophilic globule in liver

A

Councilman body (toxic or viral hepatitis, often yellow fever)

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40
Q

eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar nerve cells

A

Negri bodies of rabies

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41
Q

extracellular amyloid deposition in gray matter

A

Senile plaques - Alzheimer disease

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42
Q

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

A

Reed-Sternberg cells (Hodgkin lymphoma)

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43
Q

glomerulus-like structure surrounding vessel in germ cells

A

Schiller-Duval bodies (yolk sac tumor)

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44
Q

“hair on end” crew-cut appearance on xray

A

beta-thalassemia, sickle cell anemia (marrow expansion)

45
Q

hCG elevated

A

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

46
Q

heart nodules (granulomatous)

A

Aschoff bodies - rheumatic fever

47
Q

heterophile antibodies!

A

Mono! EBV

48
Q

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

A

bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)

49
Q

high level of D-dimers

A

DVT, PE, DIC

50
Q

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

A

Ghon complex (primary TB - Mycobacterium bacilli)

51
Q

“honeycomb lung” on CT/CXR

A

interstitial pulmonary fibrosis

52
Q

hypercoagulability (leading to migratory DVTs and vasculitis)

A

Trousseau syndrome (adenocarcinoma of pancreas or lung)

53
Q

hypersegmented neutrophils

A

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

54
Q

hypertension, hypokalemia, metabolic alkalosis

A

Conn syndrome

55
Q

hypochromic, microcytic anemia

A

IDA, lead poisoning, thalassemia (fetal Hgb sometimes present)

56
Q

increased AFP in amniotic fluid/maternal serum

A

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

57
Q

increased uric acid levels

A

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

58
Q

intranuclear eosinophilic droplet-like bodies

A

Cowdry type A bodies (HSV or CMV)

59
Q

iron-containing bodies in alveolar septum

A

ferruginous bodies (asbestosis- high change of mesothelioma)

60
Q

keratin pearls on skin biopsy

A

squamous cell carcinoma (“Squamous famous people wear pearls”)

61
Q

large, lysosomal vesicles in phagocytes, immunodeficiency

A

Chediak Higashi disease (congenital failure of phagolysosome formation)

62
Q

“lead pipe” apperance of colon on barium enema xray

A

Ulcerative colitis (loss of haustra)

63
Q

linear appearance of IgG deposition on glomerular basement membrane

A

Goodpasture

64
Q

low serum ceruloplasmin

A

Wilson disease (hepatolenticular degeneration)

65
Q

“lumpy bumpy” appearance of glomeruli on immunofluorescence

A

post-streptococcal glomerulonephritis (immune complex deposition of IgG and C3b)

66
Q

lytic (“hole-punched”) bone lesions on xray

A

multiple myeloma

67
Q

mammary gland “blue domed” cyst

A

fibrocystic change of breast

68
Q

monoclonal antibody spike

A

multiple myeloma (usually IgG or IgA), MGUS consequence of aging, Waldenstrom (M protein = IgM), primary amyloidosis

69
Q

mucin-filled cell with peripheral nucleus

A

“signet ring” - gastric carcinoma

70
Q

narrowing of bowel lumen on barium xray

A

String sign - Crohn disease

71
Q

necrotizing vasculitis (lungs) and necrotizing glomerulonephritis

A

Granulomatosis with polyangiitis (wegener and Goodpasture)

72
Q

needle-shaped, negatively birefringent crystals

A

Gout (monosodium urate crystals)

73
Q

nodular hyaline deposits in glomeruli

A

Kimmelstiel-Wilson nodules (diabetic nephropathy)

74
Q

Novobiocin sensitive

A

Staph epidermidis

75
Q

novobiocin resistant

A

Staph saprophyticus

76
Q

nutmeg appearance of liver

A

CHF –> liver congestion

77
Q

“onion skin” periosteal reaction

A

Ewing sarcoma (malignant round-cell tumor)

78
Q

Optochin sensitive

A

Strep pneumoniae

79
Q

optochin resistant

A

viridans strep

80
Q

periosteum raised from bone, creating triangular area

A

Codman triangle on xray (osteosarcoma, Ewing sarcoma, pyogenic osteomyelitis)

81
Q

podocyte fusion or effacement on EM

A

minimal change disease (child with nephrotic syndrome)

82
Q

polished “ivory-like” appearance of bone at cartilage erosion

A

eburnation - osteoarthritis resulting in bony sclerosis

83
Q

protein aggregates in neurons from hyperphophorylation of tau protein

A

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

84
Q

Psammoma bodies

A

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

85
Q

pseudopalisading tumor cells on brain biopsy

A

glioblastoma multiforme

86
Q

RBC casts in urine

A

acute glomerulonephritis

87
Q

rectangular, crystal-like cytoplasmic inclusions in Leydig cells

A

Reinke crystals (leydig cell tumor)

88
Q

renal epithelial casts in urine

A

acute toxic/viral renal injury

89
Q

rhomboid crystals, positively birefringent

A

pseudogout - calcium pyrophosphate dihydrate crystals (positively pseudo pyrophosphate)

90
Q

rib notching

A

coarctation of the aorta

91
Q

ring-enhancing brain lesion in AIDS

A

toxoplasma gondii, CNS lymphoma

92
Q

sheets of medium sized lymphoid cells with scattered pale, tingible body-laden macrophages (“starry sky”

A

Burkitt lymphoma (t8;14, c-myc activation, associated with EBV)

93
Q

silver-staining spherical aggregation of tau proteins in neurons

A

Pick bodies

94
Q

“soap bubble” in femur or tibia on xray

A

Giant cell tumor of bone (ush benign)

95
Q

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

A

membranous glomerulonephritis (may progress to nephrotic syndrome)

96
Q

stacks of RBCs

A

Rouleax formation (high ESR, multiple myeloma)

97
Q

stippled vaginal epithelial cells

A

“clue cells” - Gardnerella vaginalis

98
Q

“tennis racket” shaped cytoplasmic organelles in Langerhans cells

A

Birbeck granules - Langerhans cell histiocytosis or histiocytosis X: eosinophilic granuloma

99
Q

thrombi made of white/red layers

A

lines of Zahn - arterial thrombus, layers of platelets/RBCs

100
Q

“thumb sign” on lateral xray

A

epiglottitis - H flu

101
Q

thyroid-like appearance of kidney

A

chronic bacterial pyelonephritis

102
Q

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

A

membranoproliferative glomerulonephritis

103
Q

triglyceride accumulation in liver cell vacuoles

A

fatty liver disease - alcoholic or metabolic syndrome

104
Q

“waxy” casts with very low urine flow

A

chronic end-stage renal disease

105
Q

WBC casts in urine

A

acute pyelonephritis

106
Q

WBCs that look “smudged”- smudge cells!

A

CLL (almost always B cell)

107
Q

“wire loop” glomerular capillary appearance on light microscopy

A

Lupus nephropathy

108
Q

yellowish CSF

A

xanthrochromia - due to subarachnoid hemorrhage

USMLE Step 1 (11 decks)

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