USMLE Step 1: Clinical presentations
Clinical presentations
Clinical presentations
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Flashcards
Lab/diagnostic finding:
Giant B cells with bilobed nuclei with prominent inclusions ("owl's eye")
Diagnosis/disease:
Reed-Sternberg cells (Hodgkin's lymphoma)
Lab/diagnostic finding:
Glomerulus-like structure surrounding vessel in germ cells
DIagnosis/disease:
Schiller-Duval bodies (yolk sac tumor)
Lab/diagnostic finding:
"Hair-to-end" (crew cut) appearance on x-ray
Diagnosis/disease:
ß-thalassemia, sickle cell anemia (marrow expansion)
Lab/diagnostic finding:
hCG elevated
Diagnosis/disease:
Choriocarcinoma, hydatidiform ole (occurs with and without embryo)
Lab/diagnostic finding:
Heart nodules (granulomatous)
Diagnosis/disease:
Aschoff bodies (rheumatic fever)
Lab/diagnostic finding:
Heterophile antibodies
Diagnosis/disease:
Infectious mononucleosis (EBV)
Lab/diagnostic finding:
Hexagonal, double-pointed, needle-like crystals in bronchial secretions
Diagnosis/disease:
Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)
Lab/diagnostic finding:
High level of D-dimers
Diagnosis/disease:
Deep venous thrombosis (DVT), pulmonary embolism, DIC
Lab/diagnostic finding:
Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcifiy)
Diagnosis/disease:
Ghon complex (1° TB: Mycobacterium bacilli)
Lab/diagnostic finding:
"Honeycomb lun" on x-ray
Diagnosis/disease:
Interstitial fibrosis
Lab/diagnostic finding:
Hypersegmented neutrophils
Diagnosis/disease:
Megaloblastic anemia (B12 deficiency: neurologic symptoms; folate deficiency: no neurologic symptoms)
Lab/diagnostic finding:
Hypochromic, microcytic anemia
Diagnosis/disease:
Iron deficiency anemia, lead poisoning, thalassemia (HbF sometimes present)
Lab/diagnostic finding:
Increased alpha-fetoprotein in amniotic fluid/maternal serum
Diagnosis/disease:
Dating error, anencephaly, spina bifida
Lab/diagnostic finding:
Increased uric acid levels
Diagnosis/disease:
Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics
Lab/diagnostic finding:
Intranuclear eosinophilic droplet-like bodies
Diagnosis/disease:
Cowdry type A bodies (HSV or CMV)
Lab/diagnostic finding:
Iron-containing nodules in alveolar septum
Diagnosis/disease:
Ferruginous bodies (asbestosis: increased chance of mesothelioma)
Lab/diagnostic finding:
Large lysosomal vesicles in phagocytes, immunodeficiency
Diagnosis/disease:
Chédiak-Higashi disease (congenital failure of phagolysosome formation)
Lab/diagnostic finding:
"Lead pipe" appearance of colon on x-ray
Diagnosis/disease:
Ulcerative colitis (loss of haustra)
Lab/diagnostic finding:
Linear appearance of glomeruli on immunofluirescence
Diagnosis/disease:
Goodpasture's syndrome
Lab/diagnostic finding:
Low serum ceruloplasmin
Diagnosis/disease:
Wilson's disease (hepatolenticular degeneration)
Lab/diagnostic finding:
"Lumpy-bumpy" appearance of glomeruli on immunofluorescence
Diagnosis/disease:
Poststreptococcal glomerulonephritis (immune complex deposition of IgG and C3b)
Lab/diagnostic finding:
Lytic ("hole-punched") bone lesions on x-ray
Diagnosis/disease:
Multiple myeloma
Lab/diagnostic finding:
Mammary gland ("blue-domed") cyst
Diagnosis/disease:
Fibrocystic change of the breast
Lab/diagnostic finding:
Monoclonal antibody spike
Diagnosis/disease:
- Multiple myeloma (called the M protein; usually IgG or IgA)
- Monoclonal gammopathy of undetermined significance (MGUS; normal consequence of aging)
- Waldenström's (M protein = IgM) macroglobulinemia
- Primary amyloidosis
Lab/diagnostic finding:
Monoclonal globulin protein in blood/urine
Diagnosis/disease:
Bence Jones proteins (multiple myeloma [kappa or lambda Ig light chains in urine]), Waldenström's macroglobulinemia (IgM)
Lab/diagnostic finding:
Mucin-filled cell with peripheral nucleus
Diagnosis/disease:
Signet ring (gastric carcinoma)
Lab/diagnostic finding:
Narrowing of bowel lumen on barium radiograph
Diagnosis/disease:
"String sign" (Crohn's disease)
Lab/diagnostic finding:
Needle-shaped, negatively birefringent crystals
Diagnosis/disease:
Gout (monosodium urate crystals)
Lab/diagnostic finding:
Nodular hyaline deposits in glomeruli
Diagnosis/disease:
Kimmelstiel-Wilson nodules (diabetic nephropathy)
Lab/diagnostic finding:
Novobiocin response
Diagnosis/disease:
Sensitive: Staphylococcus epidermidis; resistant: Staphylococcus saprophyticus
Lab/diagnostic finding:
"Nutmeg" appearance of liver
Diagnosis/disease:
Chronic passive congestion of liver due to right heart failure
Lab/diagnostic finding:
"Onion-skin" periosteal reaction
Diagnosis/disease:
Ewing's sarcoma (malignant round-cell tumor)
Lab/diagnostic finding:
Optochin response
Diagnosis/disease:
Sensitive: Streptococcus pneumoniae; resistant : Viridans streptococcus
Lab/diagnostic finding:
Periosteum raised from bone, creating triangular area
Diagnosis/disease:
Codman's triangle on x-ray (osteosarcoma, Ewing's sarcoma, pyogenic osteomyelitis)
Lab/diagnostic finding:
Podocyte fusion on EM
Diagnosis/disease:
Minimal change disease (child with nephrotic syndrome)
Lab/diagnostic finding:
Polished, "ivory-like" appearance of bone at cartilage erosion
Diagnosis/disease:
Eburnation (osteoarthritis resulting in bony sclerosis)
Lab/diagnostic finding:
Protein aggregates in neurons from hyperphosphorylation of protein tau
Diagnosis/disease:
Neurofibrillary tangles (Alzheimer's disease and CJD)
Lab/diagnostic finding:
Pseudopalisading tumor cells on brain biopsy
Diagnosis/disease:
Glioblastoma multiforme
Lab/diagnostic finding:
RBC casts in urine
Diagnosis/disease:
Acute glomerulonephritis
Lab/diagnostic finding:
Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells
Diagnosis/disease:
Reinke crystals (Leydig cell tumor)
