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Flashcards in FARR Classic Labs/Findings Deck (104):
1

Anticentromere antibodies

Scleroderma (CREST)
Calcinosis
Raynaud's syndrome
Esophageal dysmotility
Sclerodactyly
Telangiectasia

2

Antidesmoglein (epithelial) antibodies

Pemphigus vulgaris (blistering)

3

Anti-glomerular basement membrane antibodies

Goodpasture's syndrome (glomerulonephritis and hemoptysis)

4

Antihistone antibodies

Drug-induced SLE (hydralazine, isoniazid, phenytoin, procainamide)

5

Anti-IgG antibodies

Rheumatoid arthritis (systemic inflammation, joint pannus, boutonniere deformity)

6

Antimitochondrial antibodies (AMAs)

1° biliary cirrhosis (female, cholestasis, portal hypertension)

7

Antineutrophil cytoplasmic antibodies (ANCAs)

Vasculitis (c-ANCA: granulomatosis with polyangiitis [Wegener's]; p-ANCA: microscopic polyangiitis, Churg­ Strauss syndrome)

8

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

SLE (type III hypersensitivity)

9

Antiplatelet antibodies

Idiopathic thrombocytopenic purpura

10

Anti-topoisomerase antibodies

Diffuse systemic scleroderma

11

Anti-transglutaminaseIanti-gliadinIanti-endomysia1 antibodies

Celiac disease (diarrhea, distention, weight loss)

12

"Apple core" lesion on abdominal x-ray

Colorectal cancer (usually left-sided)

13

Azurophilic peroxidase-positive granular inclusions in
granulocytes and myeloblasts

Auer rods (acute myelogenous leukemia, especially the promyelocytic (M3] type)

14

"Bamboo spine" on x-ray

Ankylosing spondylitis (chronic inflammatory arthritis: H LA-B27)

15

Basophilic nuclear remnants in RBCs

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

16

Basophilic stippling of RBCs

Lead poisoning or sideroblastic anemia

17

Bloody tap on LP

Subarachnoid hemorrhage

18

"Boot shaped" heart on x-ray

Tetralogy of Fallot, RVH

19

Branching gram-positive rods with sulfur granules

Actinomyces israelii

20

Bronchogenic apical lung tumor on imaging

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

21

"Brown" tumor of bone

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

22

Cardiomegaly with apical atrophy

Chagas' disease (Trypanosoma cruzi)

23

Cellular crescents in Bowman's capsule

Rapidly progressive crescentic glomerulonephritis

24

"Chocolate cyst" of ovary

Endometriosis (frequently involves both ovaries)

25

Circular grouping of dark tumor cells surrounding pale neurofibrils

Homer-Wright rosettes (neuroblastoma, medulloblastoma,
retinoblastoma)

26

Colonies ofmucoid Pseudomonas in lungs

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

27

Decreased a-fetoprotein in amniotic fluid/maternal serum

Down syndrome or other chromosomal abnormality

28

Degeneration of dorsal column nerves

Tabes dorsalis (3° syphilis), subacute combined degeneration (dorsal columns and lateral corticospinal tracts affected)

29

Depigmentation of neurons in substantia nigra

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

30

Desquamated epithelium casts in sputum

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

31

Disarrayed granulosa cells in eosinophilic fluid

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

32

Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia

Koilocytes (HPV: predisposes to cervical cancer)

33

Enlarged cells with intranuclear inclusion bodies

"Owl's eye" appearance of CMV

34

Enlarged thyroid cells with ground-glass nuclei

"Orphan Annie's eyes" nuclei (papillary carcinoma of the thyroid)

35

Eosinophilic cytoplasmic inclusion in liver cell

Mallory bodies (alcoholic liver disease)

36

Eosinophilic cytoplasmic inclusion in nerve cell

Lewy body (Parkinson's disease)

37

Eosinophilic globule in liver

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

38

Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells

Negri bodies of rabies (Lyssavirus)

39

Extracellular amyloid deposition in gray matter of brain

Senile plaques (Alzheimer's disease)

40

Giant B cells with bilobecl nuclei with prominent inclusions
("owl's eye")

Reed-Sternberg cells (Hodgkin's lymphoma)

41

Glomerulus-like structure surrounding vessel in germ cells

Schiller-Duval bodies (yolk sac tumor)

42

"Hair on end" (crew-cut) appearance on x-ray

beta-thalassemia, sickle cell anemia (marrow expansion)

43

hCG elevated

Choriocarcinoma, hydatidiform mole (occurs with and without embryo)

44

Heart nodules (granulomatous)

Aschoffbodies (rheumatic fever)

45

Heterophile antibodies

Infectious mononucleosis (EBV)

46

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

Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)

47

High level of o-dimers

DVT, pulmonary embolism, DIC

48

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

Chon complex (1 TB: Mycobacterium bacilli)

49

"Honeycomb lung" on x-ray or CT

Interstitial pulmonary fibrosis

50

Hypercoagulability (leading to migrating DVTs and vasculitis)

Trousseau's syndrome (adenocarcinoma of pancreas or lung)

51

Hypersegmented neutrophils

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

52

Hypertension, hypokalemia, metabolic alkalosis

Conn's syndrome (aldosterone-producing adenoma)

53

Hypochromic, microcytic anemia

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

54

Increased a-fetoprotein in amniotic fluid/maternal serum

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

55

Increased uric acid levels

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

56

Intranuclear eosinophilic droplet-like bodies

Cowdry type A bodies (1-ISV or CMV)

57

Iron-containing nodules in alveolar septum

Ferruginous bodies (asbestosis: increased chance of methothelioma)

58

Keratin pearls on a skin biopsy

Squamous cell carcinoma

59

Large lysosomal vesicles in phagocytes, immunodeficiency

Chediak-Higashi disease (congenital failure ofphagolysosome formation)

60

"Lead pipe" appearance of colon on barium enema x-ray

Ulcerative colitis (loss of haustra)

61

Linear appearance of lgG deposition on glomerular basement membrane

Goodpasture's syndrome

62

Low serum ceruloplasmin

Wilson's disease (hepatolenticular degeneration)

63

"Lumpy bumpy" appearance of glomeruli on immunoAuorescence

Poststrcptococcal glomerulonephritis

64

Lytic ("hole punched") bone lesions on x-ray

Multiple myeloma

65

Mammary gland ("blue domed") cyst

Fibrocystic change of the breast

66

Monoclonal antibody spike

• Multiple myeloma (usually lgG or lgA)
• Monoclonal gammopathy of undetermined significance
(MGUS ; normal consequence of aging)
• Waldenstrom's (M protein = IgM) macroglobulinemia
• Primary amyloidosis

67

Mucin-filled cell with peripheral nucleus

Signet ring (gastric carcinoma)

68

Narrowing ofbowel lumen on barium x-ray

"String sign" (Crohn's disease)

69

Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis

Granulomatosis with polyangiitis (Wegener's; c-ANCA positive) and Goodpasture's syndrome (anti-basement membrane antibodies)

70

Needle-shaped, negatively birefringent crystals

Gout (monosodium urate crystals)

71

Nodular hyaline deposits in glomeruli

Kimmelstiel-Wilson nodules (diabetic nephropathy)

72

Novobiocin response

Sensitive: Staphylococcus epidermidis; resistant: Staphylococcus saprophyticus

73

"Nutmeg" appearance of liver

Chronic passive congestion of liver due to right heart failure

74

"Onion skin" periosteal reaction

Ewing's sarcoma (malignant round-cell tumor)

75

Optochin response

Sensitive: Streptococcus pneumoniae; resistant: Viridans streptococcus

76

Periosteum raised from bone, creating triangular area

Cadman's triangle on x-ray (osteosarcoma, Ewing's sarcoma,
pyogenic osteomyelitis)

77

Podocyte fusion or "effacement" on electron microscopy

Minimal change disease (child with nephrotic syndrome)

78

Polished, "ivory like" appearance ofbone at cartilage erosion

Eburnation (osteoarthritis resulting in bony sclerosis)

79

Protein aggregates in neurons from hyperphosphorylation of
protein tau

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

80

Psammoma bodies

Meningiomas, papillary thyroid carcinoma, mesothelioma,
papillary serous carcinoma ofthe endometrium and ovary

81

Pseudopalisading tumor cells on brain biopsy

Glioblastoma multiforme

82

RBC casts in urine

Acute glomerulonephritis

83

Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells

Reinke crystals (Leydig cell tumor)

84

Renal epithelial casts in urine

Acute toxic/viral nephrosis

85

Rhomboid crystals, positively birefringent

Pseudogout (calcium pyrophosphate dihydrate crystals)

86

Rib notching

Coarctation ofthe aorta

87

Ring-enhancing brain lesion in AIDS

Toxoplasma gondii, CNS lymphoma

88

Sheets of medium-sized lymphoid cells with scattered pale, tingible body-laden macrophages ("starry sky" histology)

Burkitt's lymphoma (t[8:14] c-myc activation, associated with EBV; "black sky" made up of malignant cells)

89

Silver-staining spherical aggregation of tau proteins in neurons

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

90

"Soap bubble" in femur or tibia on x-ray

Giant cell tumor ofbone (generally benign)

91

"Spikes" on basement membrane, "dome like" subepithelial deposits

Membranous glomerulonephritis (may progress to nephrotic
syndrome)

92

Stacks of RBCs

Rouleaux formation (high ESR, multiple myeloma)

93

Stippled vaginal epithelial cells

"Clue cells" (Gardnerella vagina/is)

94

"Tennis racket" shaped cytoplasmic organelles (EM) in
Langerhans cells

Birbeck granules (Langerhans cell histiocytosis or
histiocytosis X: eosinophilic granuloma)

95

Thrombi made of white/red layers

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

96

"Thumb sign" on lateral x-ray

Epiglottitis (Haemophilus influenzae)

97

Thyroid-like appearance of kidney

Chronic bacterial pyelonephritis

98

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

Membranoproliferative glomerulonephritis

99

Triglyceride accumulation in liver cell vacuoles

Fatty liver disease (alcoholic or metabolic syndrome)

100

"Waxy" casts with very low urine flow

Chronic end-stage renal disease

101

WBC casts in urine

Acute pyelonephritis

102

WBCs that look "smudged"

CLL (almost always B cell)

103

"Wire loop" glomerular capillary appearance on light microscopy

Lupus nephropathy

104

Yellowish CSF

Xanthochromia (e.g., due to subarachnoid hemorrhage)