USMLE Step 1 Cards Editable Flashcards
1
Q
Abdominal pain, ascites, and hepatomegaly
A
Budd-Chiari syndrome (posthepatic venous thrombosis)
2
Q
Achilles tendon xanthoma
A
Familial hypercholesterolemia (dec LDL receptor signaling), AutoDom
3
Q
Adrenal hemorrhage, hypotension, DIC
A
Waterhouse-Friderichsen Syndrome (meningococcemia)
4
Q
Anterior Drawer Sign (positive)
A
Anterior cruciate ligament injury
5
Q
Arachnodactyly, lens dislocation, aortic dissection, hyperflexible joints
A
Marfan syndrome (fibrillin defect)
6
Q
Athlete with polycythemia
A
Secondary to erythropoietin injection
7
Q
Back pain, fever, night sweats, weight loss
A
Pott disease (vertebral TB)
8
Q
Bilateral hilar adenopathy, uveitis
A
Sarcoidosis (noncaseating granulomas)
9
Q
Blue sclera
A
Osteogenesis imperfecta (type I collagen defect)
10
Q
Bluish line on gingiva
A
Burton line (lead poisoning)
11
Q
Bone pain, bone enlargement, arthritis
A
Paget disease of bone (increased osteoclastic and osteoblastic activity)
12
Q
Bounding pulses, diastolic heart murmur, head bobbing
A
Aortic regurgitation
13
Q
“Butterfly” facial rash and Raynaud phenomenon in young female
A
Systemic lupus erythematosus
14
Q
Cafe-au-lait spots, Lisch nodules (iris hamartoma)
A
Neurofibromatosis Type I (+ pheochromocytoma, optic gliomas), Chromo 17.
15
Q
Cafe-au-lait spots, polyostotic fibrous dysplasia, precocious puberty, multiple endocrine abnormalities
A
McCune-Albright Syndrome (mosaic G-protein signaling mutation)
16
Q
Calf pseudohypertrophy
A
Muscular dystrophy (most commonly Duchenne): X linked recessive DELETION of dystrophin gene. Presents early. Becker’s presents in teens, DECREASED production.
17
Q
“Cherry-red spots” on macula
A
Niemann-Pick (sphingomyelin accumulation, HEPATOSPLENOMEGALY) or Tay-Sachs (ganglioside accumulation, NO HSM) or, central retinal artery occlusion.
18
Q
Chest pain on exertion
A
Angina (stable: with moderate exertion; unstable: with minimal exertion)
19
Q
Chest pain, pericardial effusion/friction rub, persistent fever following MI
A
Dressler syndrome (autoimmune-mediated post-MI fibrinous pericarditis, 1-12 weeks after acute episode)
20
Q
Child uses arms to stand up from squat
A
Gowers Sign (Duchenne muscular dystrophy)
21
Q
Child with fever later develops red rash on face that spreads to body
A
“Slapped cheeks” (erythemia infectiosum/fifth disease: parvovarius B19. Aplastic Anemia in sickle cell/hereditary spherocytosis)
22
Q
Chorea, dementia, caudate degeneration
A
Huntington disease (autosomal dominant CAG repeat expansion). Disease shows “anticipation”.
23
Q
Chronic exercise intolerance with myalgia, fatigue, painful cramps, and myoglobulinuria
A
McArdle Disease (muscle glycogen phosphorylase deficiency)
24
Q
Cold interolerance
A
Hypothyroid
25
Conjugate lateral gaze palsy, horizontal diplopia
Internuclear ophthalmoplegia (damage to MLF [medial longitudinal fasciculus]; bilateral [multiple sclerosis] or unilateral [stroked])
26
Continuous machine-like heart murmur
PDA (close with indomethacin; open or maintain with misoprostol)
27
Cutaneous/dermal edema due to connective tissue deposition
Myxedema (caused by hypothyroidism, Graves disease [pretibial])
28
Dark purple skin/mouth nodules in a patient with AIDS
Kaposi sarcoma, associated with HHV-8
29
Deep, labored breathing/hyperventilation
Kussmaul respirations (diabete ketoacidosis)
30
Dermatitis, dementia, diarrhea
Pellagra (niacin [Vitamin B3] deficiency)
31
Dog or cat bite resulting in infection
Pasteurella multocida (cellulitis at inoculation site)
32
Dilated cardiomyopathy, edema, alcoholism or malnutrition
Wet beriberi (thiamine [Vitamin B1] deficiency)
33
Dry eyes, dry mouth, arthritis
Sjogren syndrome (autoimmune destruction of exocrine glands)
34
Dysphagia (esophageal webs), glossitis, iron deficiency anemia
Plummer-Vinson syndrome (may progress to esophageal squamous cell carcinoma)
35
Elastic skin, hypermobility of joints
Ehlers-Danlos syndrome (Type III collagen defect)
36
Enlarged, hard left supraclavicular nodes
Virchow's Node (abdominal metastasis)
37
Erythroderma, lymphadenopathy, hepatosplenomegaly, atypical T cells
Mycosis fungoides (cutaneous T-cell lymphoma) or Sezary Syndrome (mycosis fungoides + malignant T cells in blood)
38
Facial muscle spasm during tapping
Chvostek sign (hypocalcemia)
39
Fat, female, forty, and fertile
Cholelithiasis (gallstones)
40
Fever, chills, headache, myalgia following antibiotic treatment for Syphilis
Jarisch-Herxheimer reaction (rapid lysis of spirochetes results in toxin release)
41
Fever, cough, conjunctivitis, coryza, diffuse rash
Measles
42
Fever, night sweats, weight loss
B symptoms (staging) of lymphoma
43
Gout, intellectual disability, self-mutilating behavior in boy
Lesch-Nyhan Syndrome (HGPRT deficiency, X-linked recessive)
44
Fibrous plaques in soft tissue of penis
Peyronie disease (connective tissue disorder)
45
Green-yellow rings around peripheral cornea
Kayser-Fleischer rings (copper accumulation from Wilson disease); Low Ceruplasmin, low serum, high urinary copper. Treat w/ Penicilliamine
46
Hamartomatous GI polyps, hyperpigmentation of mouth/feet/hands
Peutz-Jeghers syndrome (inherited, benign polyposis can cause bowel obstruction; inc cancer risk, mainly GI)
47
Hepatosplenomegaly, osteoporosis, neurologic symptoms
Gaucher disease (glucocerebrosidase deficiency)
48
Hereditary nephritis, sensorineural hearing loss, cataracts
Alport syndrome (mutation in collagen IV)
49
Hyperphagia, hypersexuality, hyperorality, hyperdocility
Kluver-Bucy syndrome (bilateral amygdala lesion)
50
Hyperreflexia, hypertonia, Babinski sign present
UMN damage
51
Hyporeflexia, hypotonia, atrophy, fasciculations
LMN damage
52
Hypoxemia, polycythemia, hypercapnia
Blue Bloater (chronic bronchitis: hyperplasia of mucous cells)
53
Indurated, ulcerated genital lesion
Nonpainful: chancre (1˚ syphilis, Trepnenma palldium)Painful, with exudate: chancroid (Haemophilus ducreyi)
54
Infant with cleft lip/palate, micocephaly or holoprosencephaly, polydactyly, cutis aplasia
Patau syndrome (Trisomy 13)
55
Infant with failure to thrive, hepatosplenomegaly, and neurodegeneration
Niemann-Pick disease (genetic phingomyelinase deficiency)
56
Infant with hypoglycemia, failure to thrive, and hepatomegaly
Cori disease (debranching enzyme deficiency, alpha- 1,6 glucosidase) or Von Gierke disease (glucose-6-phosphatase deficiency, more severe, lactate)
57
Infant with microcephaly, rocker-bottom feet, clenched hands, and structural heart defect
Edwards syndrome (trisomy 18)
58
Jaundice, palpable distended non-tender gallbladder
Courvoisier sign (distal obstruction of biliary tree)
59
Large rash with bull's-eye appearance
Erythemia chronicum migrans form Ixodes tick bite (Lyme disease: Borrelia)
60
Lucid interval after traumatic brain injury
Epidural hematoma (middle meningeal artery rupture)
61
Male child, recurrent infections, no mature B cells
Bruton disease (X-linked agammaglobulinemia due to bad bruton's tyrosine kinase)
62
Mucosal bleeding and prolonged bleeding time
Glanzmann thrombasthenia (defect in platelet aggregation due to lack of GpIIb/IIIa)
63
Muffled heart sounds, distended neck veins, hypotension
Beck triad of cardiac tamponade (pressure on the heart that occurs when blood or fluid builds up in the space between the heart muscle [myocardium] and the outer covering sac of the heart [pericardium])
64
Myopathy (infantile hypertrophic cardiomyopathy), exercise intolerance
Pompe Disease (lysosomal alpha-1,4-glucosidase deficiency)
65
Neonate with arm paralysis following difficult birth
Erb-Duchenne palsy (superior trunk [C5-C6] brachial plexus injury: waiter's tip)
66
No lactation postpartum, absent menstruation, cold intolerance
Sheehan syndrome (pituitary infarction)
67
Nystagmus, intention tremor, scanning speech, bilateral internuclear ophthalmoplegia
Multiple Sclerosis
68
Oscillating slow/fast breathing
Cheyne-Stokes respirations (central apnea in CHF or increased intracranial pressure)
69
Painful blue fingers/toes, hemolytic anemia
Cold agglutinin disease (autoimmune hemolytic anemia caused by Mycoplasma penumoniae, infectious mononucleosis)
70
Painful, pale, cold fingers/toes
Raynaud phenomenon (vasospasm in extremities)
71
Painful, raised red lesions on pad of fingers/toes
Osler nodes (infective endocarditis, immune complex deposition)
72
Painless erythematous lesions on palms and soles
Janeway lesions (infective endocarditis, septic emboli/microabscesses)
73
Painless jaundice
Cancer of the pancreatic head obstructing bile duct
74
Palpable purpura on buttocks/legs, joint pain (child), hematuria
Henoch-Schonlein purpura (IgA vasculitis affecting skin and kidneys)
75
Pancreatic, pituitary, parathyroid tumors
MEN I (autosomal dominant)
76
Pink complexion, dyspnea, hyperventilation
Pink Puffer: emphysema: centriacinar [smoking], panacinar [alpha1-antitrypsin deficiency], PAS + staining)
77
Polyuria, renal tubular acidosis Type II, growth failure, electrolyte imbalances, hypophosphatemic rickets
Fanconi syndrome (proximal tubular reabsorption defect)
78
Pruritic, purple, polygonal planar papules and plaques
Lichen planus
79
Ptosis, miosis, anhidrosis
Horner Syndrome (sympathetic chain lesion)
80
Pupil accommodates but doesn't react
Argyll Robertson pupil (neurosyphilis)
81
Rapidly progressive leg weakness that ascends following GI/upper respiratory infection
Guillian-Barre syndrome (acute autoimmune inflammatory demyelinating polyneuropathy); camplobacter jejuni
82
Rash on palms and soles
Coxsackie A, 2˚ syphilis, Rocky Mountain Spotted fever
83
Recurrent colds, unusual eczema, high serum IgE
Hyper-IgE syndrome (Job syndrome: neutrophil chemotaxis abnormality)
84
Red current jelly sputum in alcoholic or diabetic patient
Klebsiella penumoniae
85
Red current jelly stools
Acute mesenteric ischemia (adults), intussusception (infants)
86
Red, itchy, swollen rash of nipple/aerolea
Paget disease of the breast (sign of underlying neoplasm)
87
Red urine in the morning, fragile RBCs
Paroxysmal nocturnal hemoglobinuria (no PIG therefore cannot attach DAF (CD55) and MIRL (CD59)
88
Renal cell carcinoma (bilateral), hemagioblastomas, angiomatosis, pheechromocytoma
von Hippel-Lindau disease (dominant tumor suppressor gene mutation)
89
Resting tremor, rigidity, akinesia, postural instability
Parkinson disease (nigrostriatal dopamine depletion)
90
Retinal hemorrhages with pale centers
Roth spots (bacterial endocarditis)
91
Severe jaundice in neonate
Crigler-Najjar syndrome (congenital unconjugated hyperbilirubinemia)
92
Severe RLQ pain with palpation of LLQ
Rovsing sign (acute appendicitis)
93
Severe RLQ pain with rebound tenderness
McBurney sign (acute appendicitis)
94
Short stature, inc incidence of tumors/leukemia, aplastic anemia
Fanconi anemia (genetic loss of DNA crosslink repair; often progresses to AML)
95
Single palmar crease
Down Syndrome
96
Situs inversus, chronic sinusitis, bronchiectasis, infertility
Kartagener syndrome (dyenien arm defect affecting cilia)
97
Skin hyperpigmentation, hypotension, fatigue
Addison disease (1˚ adrenocortical insufficiency causes inc ACTH and inc alpha-MSH production)
98
Slow, progressive muscle weakness in boys
Becker muscular dystrophy (X linked missense mutation in dystrophin; less severe than Duchenne)
99
Small, irregular red spots on buccal/lingual mucosa with blue-white centers
Koplik spots (measles; rubeola virus: "measles gets all the "PRESSN": Paramyoxviridae, RNA, Env, Single Stranded, Negative)
100
Smooth, flat, moist, painless white lesions on genitals
Condylomata lata (2˚ syphilis)
101
Splinter hemorrhages in fingernails
Bacterial endocarditis
102
Strawberry tongue
Scarlet fever, Kawasaki disease, toxic shock syndrome
103
Streak ovaries, congenital heart disease, horseshoe kidney, cystic hygroma at birth, short stature, webbed neck, lymphedema
Turner syndrome (45, XO)
104
Sudden swollen/painful big toe joint, tophi
Gout/podagra (hyperuricemia)
105
Swollen gums, mucosal bleeding, poor wound healing, petechiae
Scurvy (Vitamin C deficiency: can't hydroxylate proline/lysine for collagen synthesis)
106
Swollen, hard, painful finger joints
Osteoarthritis (osteophytes on PIP [Bouchard nodes], DIP [Heberden nodes])
107
Systolic ejection murmur (cresendo-decrescendo)
Aortic valve stenosis
108
Thyroid and parathyroid tumors, pheochromocytoma
MEN 2A (autosomal dominant ret mutation)
109
Thyroid tumors, pheochromocytoma, ganglioneuromatosis, Marfinoid body habitus
MEN 2B (autosomal dominant ret mutation)
110
Toe extension/fanning upon plantar scrape
Babinski sign (UMN lesion)
111
Unilateral facial dropping involving forehead
Facial nerve (LMN CN VII palsy)
112
Urethritis, conjunctivitis, arthritis in a male
Reactive (Reiters) arthritis associated with HLA-B27 (can't pee, can't see, can't climb a tree); associated with recent GI infection or Chlamydia infection
113
Vascular birthmark (port-wine stain)
Hemangioma (benign, but associated with Sturge-Weber syndrome)
114
Vomiting blood following gastroesophageal lacerations
Mallory-Weiss syndrome (alcoholic and bulimic patients)
115
Weight loss, diarrhea, arthritis, fever, adenopathy
Whipple disease (Tropheryma whipplei: foamy macrophages (PAS+) in the lamina propria)
116
Worst headache of life
Subarachnoid hemorrhage
117
Anticentromere antibodies
Scleroderma (CREST)
118
Antidesmoglein (epithelial) antibodies
Pemphigus vulgaris (blistering), Positive Nikolsky Sign
119
Anti-glomerular basement membrane antibodies
Goodpasture syndrome (glomerulonephritis & hemoptysis), against Type 4 collagen
120
Antihistone antibodies
Drug-induced SLE (SHIPP: Sulfonamides, hydralazine, INH, phenytoin, procainamide):
121
Anti-IgG antibodies
Rheumatoid arthritis (systemic inflammation, joint pannus, boutonniere deformity)
122
Antimitochondrial antibodies (AMAs)
1˚ biliary cirrhosis (female, cholestasis, portal HTN)
123
MPO-ANCA/p-ANCA
Microscopic polyangiitis & Churg-Strauss syndrome
124
PR3-ANCA/c-ANCA
Granulomatosis w/polyangiitis (Wegener)
125
Antinuclear antibodies (anti-Smith & anti-dsDNA)
SLE (type III hypersensitivity)
126
Antiplatelet antibodies
Idiopathic thrombocytopenic purpura
127
Anti-topoisomerase antibodies
Diffuse systemic scleroderma
128
Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies
Celiac disease (diarrhea, distention, weight loss)
129
Apple core lesion on abdominal x-ray
Colorectal cancer (usually left-sided)
130
Azurophilic peroxidase (+) granular inclusions in granulocytes & myeloblasts
Auer rods (AML, especially the promyelocytic [M3] type)
131
Bacitracin response
Sensitive: Steptococcus pyogenes (Group A); resistant: streptococcus agalactiae (Group B)
132
Bamboo spine on x-ray
Ankylosing spondylitis (chronic inflammatory arthritis; HLA-B27)
133
Basophilic nuclear remnants in RBCs
Howell-Jolly bodies (d/t splenectomy or nonfunctional spleen)
134
Basophilic stippling of RBCs
Lead poisoning or Sideroblastic anemia
135
Bloody tap on LP
Subarachnoid hemorrhage
136
Boot-shaped heart on x-ray
Tetralogy of Fallot, RVH
137
Branching gram-positive rods w/sulfur granules
Actinomyces israelii
138
Bronchogenic apical lung tumor on imaging
Pancoast tumor (can compress sympathetic ganglion & cause Horner syndrome)
139
Brown tumor of bone
Hyperparathyroidism or osteitis fibrosa cystica (deposited hemosiderin from hemorrhage gives brown color)
140
Cardiomegaly with apical atrophy
Chagas disease (Trypanosoma cruzi)
141
Cellular crescents in Bowman capsule
Rapidly progressive crescentic glomerulonephritis
142
Chocolate cyst of ovary
Endometriosis (frequently involves both ovaries)
143
Circular grouping of dark tumor cells surrounding pale neurofibrils
Homer-Wright rosettes (neuroblastoma, medulloblastoma, retinoblastoma)
144
Colonies of mucoid Pseudomonas in lungs
Cystic fibrosis (autosomal recessive mutation in CFTR gene --> fat-soluble vitamin deficiency and mucous plugs)
145
Dec AFP in amniotic fluid/maternal serum
Down syndrome or other chromosomal abnormality
146
Degeneration of dorsal column nerves
Tabes dorsalis (3˚ syphilis), subacute combined degeneration (dorsal columns & lateral corticospinal tracts affected)
147
Depigmentation of neurons in substantia nigra
Parkinson disease (basal ganglia disorder; rigidity, resting tremor, bradykinesia)
148
Desquamated epithelium casts in sputum
Curschmann spirals (bronchial asthma; can result in whorled mucous plugs)
149
Disarrayed granulosa cells in eosinophilic fluid
Call-Exner bodies (granulosa-theca cell tumor of ovary)
150
Dysplastic squamous cervical cells w/nuclear enlargement & hyperchromasia
Koilocytes (HPV; predisposes to cervical cancer)
151
Enlarged cells with intranuclear inclusion bodies
Owl eye appearance of CMV
152
Enlarged thyroid cells with ground glass nuclei
Orphan Annie eyes nuclei (papillary carcinoma of thyroid)
153
Eosinophilic cytoplasmic inclusion in liver cell
Mallory body (alcoholic liver disease)
154
Eosinophilic cytoplasmic inclusion in nerve cell
Lewy body (Parkinson disease)
155
Eosinophilic globule in liver
Councilman body (toxic or viral hepatitis, often yellow fever)
156
Eosinophilic inclusion bodies in cytoplasm of hippocampal & cerebellar nerve cells
Negri bodies of rabies
157
Extracellular amyloid deposition in gray matter of brain
Senile plaques (Alzheimer disease)
158
Giant B cells w/bilobed nuclei with prominent inclusions ("owl's eye")
Reed-Sternberg cells (Hodgkin lymphoma)
159
Glomerulus-like structure surrounding vessel in germ cells
Schiller-Duval bodies (yolk sac tumor)
160
Hair on end (crew-cut) appearance on x-ray
beta-Thalassemia, sickle cell anemia (marrow expansion)
161
hCG elevated
Choriocarcinoma, hydatidiform mole (occurs w/& w/o embryo, and multiple pregnancy)
162
Heart nodules (granulomatous)
Aschoff bodies (rheumatic fever)
163
Heterophile antibodies
Infectious mononucleosis (EBV)
164
Hexagonal, double-pointed, needle-like crystals in bronchial secretions
Bronchial asthma (Charcot-Leyden crystals; eosinophilic granules)
165
High level of D-dimers
DVT, PE, DIC
166
Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Ghon complex (1˚ TB; Mycobacterium bacilli)
167
Honeycomb lung on x-ray or CT
Interstitial pulmonary fibrosis
168
Hypercoagulability (leading to migrating DVTs and vasculitis)
Trousseau syndrome (adenocarcinoma of pancreas or lung)
169
Hypersegmented neutrophils
Megaloblastic anemia (B12 deficiency - neurologic symptoms; folate deficiency - no neurologic symptoms)
170
Hypertension, hypokalemia, metabolic alkalosis
Conn syndrome
171
Hypochromic, microcytic anemia
Iron deficiency anemia, lead poisoning, thalassemia (fetal Hg sometimes present)
172
Increased AFP in amniotic fluid/maternal serum
Dating error, anencephaly, spina bifida (neural tube defects)
173
Increased uric acid levels
Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics
174
Intranuclear eosinophilic droplet-like bodies
Cowdry type A bodies (HSV or CMV)
175
Iron-containing nodules in alveolar septum
Ferruginous bodies (asbestosis inc chance of mesothelioma)
176
Keratin pearls on a skin biopsy
Squamous cell carcinoma
177
Large lysosomal vesicles in phagocytes, immunodeficiency
Chediak-Higashi disease (congenital failure of phagolysososome formation)
- partial albinism
- neuropathy
178
Lead pipe appearance of colon on barium enema x-ray
Ulcerative colitis (loss of haustra)
179
Linear appearance of IgG depostion on glomerular basement membrane
Goodpasture syndrome
180
Low serum ceruloplasmin
Wilson disease (hepatolenticular degeneration)
181
Lumpy bumpy appearance of glomeruli on immunofluorescence
Poststreptococcal glomerulonephritis (immune complex deposition on IgG and C3b)
182
Lytic ("hole punches") bone lesions on x-ray
Multiple myeloma
183
Mammary gland ("blue domed") cyst
Fibrocystic change of the breast
184
Monoclonal antibody spike (IgG or IgA)
Multiple myeloma (usually IgG or IgA)
185
Monoclonal antibody spike
Monoclonal gammopathy of undetermined significance (MGUS consequence of aging); Primary amyloidosis
186
Monoclonal antibody spike (IgM)
Waldestrom (M protein = IgM) macroglobulinemia
187
Mucin-filled cell with peripheral nucleus
Signet ring (gastric carcinoma)
188
Narrowing of bowel lumen on barium x-ray
String sign (Crohn disease)
189
Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis
Granulomatosis with polyangiitis (Wegener; PR3-ANCA/c-ANCA) and Goodpasture syndrome (anti-basement membrane antibodies)
190
Needle-shaped, negatively birefringent crystals
Gout (monosodium urate crystals)
191
Nodular hyaline deposits in glomeruli
Kimmelstiel-Wilson nodules (diabetic nephropathy)
192
Novobiocin response
Sensitive: Staphylococcus epidermiditis; resistant: staphylococcus saprophyticus
193
Nutmeg appearance of liver
Chronic passive congestion of liver due to right heart failure
194
Onion skin periosteal reaction
Ewing sarcoma (malignant round-cell tumor)
195
Optochin response
Sensitive: Streptococcus pneumoniae; resistant: viridans streptococci
196
Periosteum raised from bone, creating triangular area
Codman triangle on x-ray (osteosarcoma, Ewing sarcoma, pyogenic osteomyelitis)
197
Podocyte fusion or "effacement" on electron microscopy
Minimal change disease (child with nephrotic syndrome)
198
Polished, "ivory-like" appearance of bone at cartilage erosion
Eburnation (osteoarthritis resulting in bony sclerosis)
199
Protein aggregates in neurons from hyperphosphorylation of tau protein
Neurofibrillary tangles (Alzheimer disease) and Pick bodies (Pick disease)
200
Psammoma bodies
Meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of the endometrium and ovary
201
Pseudopalisading tumor cells on brain biopsy
Gioblastoma multiforme
202
RBC casts in urine
Acute glomerulonephritis
203
Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells
Reinke crystals (Leydig cell tumor)
204
Renal epithelial casts in urine
Acute toxic/viral renal injury
205
Rhomboid crystals, positively birefringent
Pseudogout (calcium pyrophosphate dihydrate crystals)
206
Rib notching
Coarctation of the aorta
207
Ring-enhancing brain lesions in AIDS
Toxoplasma gondii, CNS lymphoma
208
Sheets of medium-sized lymphoid cells with scattered pale, tangible body-laden macrophages ("starry sky" histology)
Burkitt lymphoma (t[8:14] c-myc activation, associated with EBV; "black sky" made up of malignant cells)
209
Silver-staining spherical aggregation of tau proteins in neurons
Pick bodies (Pick disease; progressive dementia, changes in personality)
210
Soap bubble in femur or tibia on x-ray
Giant cell tumor of bone (generally benign)
211
Spikes on basement membrane, "dome-like" subepithelial deposits
Membranous glomerulonephritis (may progress to nephrotic syndrome)
212
Stacks of RBCs
Rouleaux formation (high ESR, multiple myeloma)
213
Stippled vaginal epithelial cells
Clue cells (Gardnerella vaginalis)
214
Tennis racket-shaped cytoplasmic organelles (EM) in Langerhans cells
Birbeck granules (Langerhans cell histiocytosis or histiocytosis X; eosinophilic granuloma)
215
Thrombi made of white/red layers
Lines of Zahn (arterial thrombus, layers of platelets/RBCs)
216
Thumb sign on lateral x-ray
Epiglottitis (Haemophilus influenzae)
217
Thyroid-like appearance of kidney
Chronic bacterial pyelonephritis
218
Tram-tack appearance of capillary loops of glomerular basement membranes on light microscopy
Membranoproliferative glomerulonephritis
219
Triglyceride accumulation in liver cell vacuoles
Fatty liver disease (alcoholic or metabolic syndrome)
220
Waxy casts with very low urine flow
Chronic end-stage renal disease
221
WBC casts in urine
Acute pyelonephritis
222
WBCs that look "smudged"
CLL (almost always B cell)
223
Wire loop glomerular capillary appearance on light microscopy
Lupus nephropathy
224
Yellowish CSF
Xanthochromia (e.g. subarachnoid hemorrhage due to Bilirubin breakdown products)
225
Short Stature, Short 4th and 5th digits, Hypocalcemia
Psuedohypoparathryoidism. Inactivating mutation of Gsalpha which cannot stimulate Adenylate Cyclase leading to decreased cAMP, leaving body unable to respond to PTH.
226
Headache in a firefighter
CO exposure. Early sign of CO poisoning is headache
227
Symptoms of HyperPTH
"Bones, stones, moans (psychiatric), and groans (GI)"
228
Myotonia, Muscle Wasting, Frontal Balding, Cataracts, Testicular atrophy, Arrhythmia
Myotonic Dystrophy
229
Pharyngoconjunctival Fever
Adenovirus
