USMLE Step 1 First Aid 2011 Rapid Review
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86 terms
Terms | Definitions |
|---|---|
 Antimitochondrial antibodies (AMAs) | 1° biliary cirrhosis (female, cholestasis, portal hypertension) |
| Antineutrophil cytoplasmic antibodies (ANCAs) | Vasculitis (c-ANCA: Wegener's; p-ANCA: microscopic polyangiitis, Churg-Strauss syndrome) |
| Antinuclear antibodies (ANAs: anti-Smith and anti-dsDNA) | SLE (type III hypersensitivity) |
| Antiplatelet antibodies | Idiopathic thrombocytopenic purpura (lTP) (bleeding diathesis) |
| Anti-topoisomerase antibodies | Diffuse systemic scleroderma |
| Anti-transglutaminase / antigliadin / anti-endomysial antibodies | Celiac disease (diarrhea, distention, weight loss) |
| Azurophilic granular needles in leukemic blasts | Auer rods (acute myelogenous leukemia: especially the promyelocytic type) |
| "Bamboo spine" on x-ray | Ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27) |
| Basophilic nuclear remnants in RBCs | Howell-Jolly bodies (due to splenectomy or nonfunctional spleen) |
| Basophilic stippling of RBCs | Lead poisoning or sideroblastic anemia |
| Bloody tap on LP | Subarachnoid hemorrhage |
| "Boot-shaped" heart on x-ray | Tetralogy of Fallot, RVH |
| Branching gram-positive rods with sulfur granules | Actinomyces israelii |
| Bronchogenic apical lung tumor | Pancoast's tumor (can compress sympathetic ganglion and cause Horner's syndrome) |
| "Brown" tumor of bone | Hemorrhage (hemosiderin) causes brown color of osteolytic cysts. Due to:1. Hyperparathyroidism, 2. Osteitis fibrosa cystica |
| Cardiomegaly with apical atrophy | Chagas' disease (Trypanosoma cruzi) |
| Cellular crescents in Bowman's capsule | Rapidly progressive crescentic glomerulonephritis |
| "Chocolate cyst" of ovary | Endometriosis (frequently involves both ovaries) |
| Circular grouping of dark tumor cells surrounding pale neurofibrils | Homer Wright rosettes (neuroblastoma, medulloblastoma, retinoblastoma) |
| Colonies of mucoid Pseudomonas in lungs | Cystic fibrosis (CFTR mutation in Caucasians resulting in fat-soluble vitamin deficiency and mucous plugs) |
| Degeneration of dorsal column nerves | Tabes dorsalis (3° syphilis) |
| Depigmentation of neurons in substantia nigra | Parkinson's disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia) |
| Desquamated epithelium casts in sputum | Curschmann's spirals (bronchial asthma; can result in whorled mucous plugs) |
| Disarrayed granulosa cells in eosinophilic fluid | Call-Exner bodies (granulosa-theca cell tumor of the ovary) |
| Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia | Koilocytes (HPV: predisposes to cervical cancer) |
| Enlarged cells with intranuclear inclusion bodies | "Owl's-eye" appearance of CMV |
| Enlarged thyroid cells with ground-glass nuclei | "Orphan Annie" eye nuclei (papillary carcinoma of the thyroid) |
| Eosinophilic cytoplasmic inclusion in liver cell | Mallory bodies (alcoholic liver disease) |
| Eosinophilic cytoplasmic inclusion in nerve cell | Lewy body (Parkinson's disease) |
| Eosinophilic globule in liver | Councilman body (toxic or viral hepatitis, often yellow fever) |
| Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells | Rabies virus (Lyssavirus) |
| Extracellular amyloid deposition in gray matter of brain | Senile plaques (Alzheimer's disease) |
| Giant B cells with bilobed nuclei with prominent inclusions ("owl's eye") | Reed-Sternberg cells (Hodgkin's lymphoma) |
| Glomerulus-like structure surrounding vessel in germ cells | Schiller-Duval bodies (yolk sac tumor) |
| "Hair-on-end" (crew-cut) appearance on x-ray | β-thalassemia, sickle cell anemia (extramedullary hematopoiesis) |
| hCG elevated | Choriocarcinoma, hydatidiform mole (occurs with and without embryo) |
| Heart nodules (inflammatory) | Aschoff bodies (rheumatic fever) |
| Heterophile antibodies | Infectious mononucleosis (EBV) |
| Hexagonal, double-pointed, needle-like crystals in bronchial secretions | Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules) |
| High level of D-dimers | DVT, pulmonary embolism, DIC |
| Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify) | Ghon focus (1° TB: Mycobacterium bacilli) |
| "Honeycomb lung" on x-ray | Interstitial fibrosis |
| Hypersegmented neutrophils | Megaloblastic anemia (B12, folate deficiency) |
| Hypochromic, microcytic anemia | Iron deficiency anemia, lead poisoning, thalassemia (HbF sometimes present) |
| Increased α-fetoprotein in amniotic fluid/maternal serum | Anencephaly, spina bifida (neural tube defects) |
| Increased uric acid levels | Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics |
| Intranuclear eosinophilic droplet-like bodies | Cowdry type A bodies (HSV or yellow fever) |
| Iron-containing nodules in alveolar septum | Ferruginous bodies (asbestosis: ↑ chance of mesothelioma) |
| Large lysosomal vesicles in phagocytes, immunodeficiency | Chediak-Higashi disease (congenital failure of phagolysosome formation) |
| Low serum ceruloplasmin | Wilson's disease (hepatolenticular degeneration) |
| "Lumpy-bumpy" appearance of glomeruli on immunofluorescence | Poststreptococcal glomerulonephritis (immune complex deposition of IgG and C3b) |
| Lytic ("hole-punched") bone lesions on x-ray | Multiple myeloma |
| Mammary gland ("blue-domed") cyst | Fibrocystic change of the breast |
| Monoclonal antibody spike | 1. Multiple myeloma (called the M protein; usually IgG or IgA); 2. Monoclonal gammopathy of undetermined significance (MGUS; normal consequence of aging); 3. Waldenstriim's (M protein = IgM) macroglobulinemia; 4. Primary amyloidosis |
| Monoclonal globulin protein in blood/urine | Bence Jones proteins (multiple myeloma [kappa or lambda Ig light chains in urine]), Waldenstrom's macroglobulinemia (lgM) |
| Mucin-filled cell with peripheral nucleus | Signet ring (gastric carcinoma) |
| Narrowing of bowel lumen on barium radiograph | "String sign" (Crohn's disease) |
| Needle-shaped, negatively birefringent crystals | Gout (hyperuricemia) |
| Nodular hyaline deposits in glomeruli | Kimmelstiel-Wilson nodules (diabetic nephropathy) |
| "Nutmeg" appearance of liver | Chronic passive congestion of liver due to right heart failure |
| "Onion-skin" periosteal reaction | Ewing's sarcoma (malignant round-cell tumor) |
| Periosteum raised from bone, creating triangular area | Codman's triangle on x-ray (osteosarcoma, Ewing's sarcoma, pyogenic osteomyelitis) |
| Podocyte fusion on EM | Minimal change disease (child with nephrotic syndrome) |
| Polished, "ivory-like" appearance of bone at cartilage erosion | Eburnation (osteoarthritis resulting in bony sclerosis) |
| Protein aggregates in neurons from hyperphosphorylation of protein tau | Neurofibrillary tangles (Alzheimer's disease and CJD) |
| Pseudopalisading tumor cells on brain biopsy | Glioblastoma multiforme |
| RBC casts in urine | Acute glomerulonephritis |
| Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells | Reinke crystals (Leydig cell tumor) |
| Renal epithelial casts in urine | Acute toxic/viral nephrosis |
| Rhomboid crystals, positively birefringent | Pseudogout (calcium pyrophosphate dihydrate) |
| Rib notching | Coarctation of the aorta |
| Sheets of medium-sized lymphoid cells ("starry sky" appearance on histology) | Burkitt's lymphoma (t[8:14] c-myc activation, associated with EBV) |
| Silver-staining spherical aggregation of tau proteins in neurons | Pick bodies (Pick's disease: progressive dementia, similar to Alzheimer's) |
| "Soap bubble" in femur or tibia on x-ray | Giant cell tumor of bone (generally benign) |
| "Spikes" on basement membrane, "dome-like" endothelial deposits | Membranous glomerulonephritis (may progress to nephrotic syndrome) |
| Stacks of red blood cells | Rouleaux formation (high ESR, multiple myeloma) |
| Stippled vaginal epithelial cells | "Clue cells" (Gardnerella vaginalis) |
| "Tennis-racket" -shaped cytoplasmic organelles (EM) in Langerhans cells | Birbeck granules (histiocytosis X: eosinophilic granuloma) |
| Thrombi made of white/red layers | Lines of Zahn (arterial thrombus, layers of platelets/RBCs) |
| "Thumb sign" on lateral x-ray | Epiglottitis (Haemophilus influenzae) |
| Thyroid-like appearance of kidney | Chronic bacterial pyelonephritis |
| "Tram-track" appearance on LM | Membranoproliferative glomerulonephritis |
| Triglyceride accumulation in liver cell vacuoles | Fatty liver disease (alcoholic or metabolic syndrome) |
| WBCs that look "smudged" | CLL (almost always B cell; affects the elderly) |
| "Wire loop" glomerular appearance on LM | Lupus nephropathy |
| Yellow CSF | Xanthochromia (subarachnoid hemorrhage) |
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