USMLE Tests/LabS – Flashcards
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Tensilon Test (Edrophonium)
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Myasthenia Gravis (Edrophonium=short acting AchE inhibitor, cause temp improve sx if pt is undertreated or not tx with Neostigimine) no improve sx if pt is in cholinergic crisis->mm weakness
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Giemsa Stain
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Borrelia Plasmodium trypanosomes Chlamydia
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PAS+
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glycogens, mucopolysaccharides Tropheryma whippelii (in liver= alpha1-antitrypsin deficiency)
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Silver stain
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Fungi (pneumocystis jiroveci= PCP) Legionella
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chocolate agar w factor X and V (hematin, NAD+)
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H influenzae
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Vanco, Polymyxin, Nystatin agar
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N. gonorrhoeae
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Loffler's media
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C. diphtheriae
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Lowenstein-jensen agar (3-4 weeks)
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TB
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Eaton's agar
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M. pneumoniae
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MacConkey's agar (crystal violet, bile salts= prevent gram +)
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Pink= Lactose fermenting enterics
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Ham's test
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Paroxysmal Nocturnal Hemoglobinuria RBC lyse at low pH
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Neg Nitroblue tetrazolium dye reduction
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CGD (lack NADPH oxidase)
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latent period
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time from exposure to outcome; chronic dz have very long latent period of continuous exposure necessary to affect outcome (not a bias, just a phenomenon)
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procedure bias
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diff groups not treated same
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pygmalion effect
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researcher's belief
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hawthorne effect
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group knows they are being studied
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Legionella
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imagine french legionairre w SILVER (stain) hat sitting around campfire w a IRON dagger, he is no CISSY (charcoal agar w iron & cysteine)
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which pt gets Technium-99m Pertechnetate study?
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for painless rectal bleed in 2 yo. Ectopic uptake of gastric mucosa at terminal ileum (RLQ) =Meckel's Diverticulum
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Weil Felix
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patient serum mixed with Proteus O Ag -->antiRickettsial Ab agglutinate except Coxiella Burnetti
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incr AFP & acetylcholinesterase
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Neural Tube defects (possible gastroschisis, omphalocele)
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Cowdry A inclusions
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infected cells with herpes intranuclear
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blue white spot on buccal mucosa
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Rubeola (measles virus) Koplik spots
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incr aFP
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hepatocell CA neural tube defects (spina bifida) abdominal wall defects ataxia-telangiectasia Yolk sac tumor
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acute hep B infxn labs
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+hepBsAg +hepBeAg +anti-hepBcAg IgM
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pos CRP and ESR
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nonspecific inflamm osteomyelitis
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lymphogranuloma venereum
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Chlamydia trichomonas L1-3 sx
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STD w strawberry colored mucosa (cervix)
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trichomonas vaginalis
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violin string adhesions of parietal peritoneum to liver
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FitzHughCurtis synd (severe gonorrheaPID)
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acid fast cysts in stool of HIV+ pt
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crytosporidium watery diarrhea
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cotton wool spots on funduscopic exam of HIV+
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CMV retinitis
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ring enhancing lesions on imaging of HIV+
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Toxoplasma gondii
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neutrophilic inflamm in HIV+ vascular prolif.
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Bartonella henselae (bacillary aniomatosis)
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Waldeyer's ring (oropharynx)
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Non-Hodgkin's lymphoma (large cell type) EBV of HIV+
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turniquet test helps diagnose hemorrhagic dz
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if petechiae--> pos test Dengue fever (breakbone fever)
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steeple sign
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xray at upper lungs bronchi= Parainfluenza croup
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anti-snRNPs or anti-smith dx
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SLE w worse prognosis
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anti-endomysal, anti-reticulin, IgA anti-tissue transanimase
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Celiac Dz antibodies (gliadin= polypeptides from gluten)
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DX: flattening of only small intestinal villi and chronic inflamm
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Celiac Sprue only does small intestines
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pos Schilling test dx
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IM B12 given to saturate liver recpters; Oral radio-B12 will absorb and pass into urine if NL. If No radiolabeled B12: consider pernicious anemia, bactera, pancreatic enzyme def
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microcystic anemia w low ferritin
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iron def anemia
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pos murphy sign + HIDA scan: NO visualization of gallbladder
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cholecystitis findings may also have incr alk phos
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myocardial perfusion scan: Dipyridamole or adenosine inj
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Coronary vasodilators- coronary steal effect (BV distal to obstruction already max dilated so inhomogenesity of distribution to non-diseased areas +Pain)
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D-dimer
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Sensitive test for detecting thrombus formation; very non-specific (elev in hospitalized pts)
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Cosyntropin test (synthetic ACTH)
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if Cosyntropin given, no rise in cortisol= primary adrenal insufficiency (TB, fungal, CMV)
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McMurray Test
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painful click w passive flexion of knee w examiner's thumb and index finger placed on the meddial&lateral joint lines. POS= meniscal injury -> MRI preferred test
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Workup for Erythema Nodosum
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CXR, PPD, ASO titers
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pronator drift specific for what type of dz
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upper motor neuron: Stroke, cerebrovascular dz
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What labs do you follow when on amiodarone?
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pulm fibrosis, hepatotox, thyroid dysfunc PFTs, LFTs, TSH
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oligoclonal bands found in what dzs?
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MS, neuropathies, viral syndromes, chronic CNS infxns
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acute phase reactants
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TNF-a, IL-1, IL-6 -> inflamm -> fibrinogen, ferritin, CRP, ESR, amyloid A, amyloid P, complement; (albumin decr)
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indirect and direct Coombs tests:
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indirect: antibody to RBCs in pt blood direct: detects sensitized RBCs (RBC has Ag that bind antibodies)
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what labs typical of microangiopathic hemolytic anemis?
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Low haptoglobin! elev LDH, shcistocytes, indirect bili,
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DECR AFP, estriol, BhCG, inhibin A
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still UNDERage= Trisomy 18
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DECR AFP, estriol INCR BhCG, inhibin A
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2 up / 2 DOWN= Trisomy 21
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guthrie test
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screens metabolic products of phenylalanine in urine=PKU
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what is albuminocytologic dissociation
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csf elev protein but normal WBC in Guillain Barre synd
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elev Cr and very low urine Na 20 w HIGH urine Na conc.
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pre-renal AKI (hypoperfusion)
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elev testosterone & LH/FSH > 2.0 (incr)`
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acne, hirsutism= PCOS
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when urethral injury suspected
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1. retrograde urethrogram prior to Foley insertion 2. or suprapubic catheter + emergent surgical repair (after healing may have stricture)
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RA press 15, Pulm a press 45/20, PCWP 9, acute SOB, hypotn, tachy, cold extremities
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Pulm HTN 2/2 COPD, L hrt dz, or PE this pt in shock from massive PE b/c nl PCWP Spiral CT angiogram, Heparin, then thrombolysis
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4 Dx tests for DM
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Random Glu >200 Fasting plasma glu >126 (2 separate occasions) Glu >200 (2hr after 75g oral load) Ha1c >6.5
