USMLE 1 microscopic findings
Terms
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- Anitschlow myocytes : reactive histiocytes
- Rheumatic fever
- Apple-green bifringence
- Amyloidosis
- Aschoff bodies : fibrinoid necrosis surrounded by multinucleated giant cells
- Rheumatic fever
- Asteroid bodies : flower-like spores at end of hyphae
- Sporothrix schenckii
-
Dx:
Asteroid bodies -
stellate inclusions w/i multinucleated giant cells
(2) -
- Noncaseating granuloma
- Sarcoidosis -
Atypical lymphocytes
(one disease cause and one drug) -
- Mononucleosis
- Phenytoin - Auer rods : cytoplasmic inclusion rods in leukocyte
- Acute promyelocytic leukemia (AML)
- Basophillic stippling of RBCs
- lead poisoning
- Birbeck granules
- histocytosis X (eosinophillic granuloma)
- Blue dome cyst
- fibrocystic disease of the breast
-
Bread and butter pericarditis
(4) -
A PURrrr:
- Acute MI
- Pericarditis, fibrinous
- Uremia
- Rheumatic fever - Big, Broad-based budding
- Blastomycosis
- Budding yeast w/ pseudohyphae
- Candida albicans
- Bullet shaped capsid
- Rabies
- Call-Exnor bodies : rosette-like structure resembling an ovarian follicle
- Granulosa cell tumor
-
Bug:
Captain's wheel -
Paracoccidiomycosis
[PARAot on the Captain] - Catepillar cardiac myocytes in longitudinal section
- Rheumatic fever
- Charcot-Leyden crystals : refractile crystals seen in eosinophils
- bronchial asthma
- Chocolate cysts
- endometriosis
- Cigar shaped budding yeast
- Sporothrix schencki
- Clue cells : epithelial cells w adherent bacteria
- Gardnerella vaginitis
- Councilman bodies : eosinophillic inclusions w/i dying hepatocytes
- Yellow fever
- Crescents in Bowman's capsule
- rapidly progressive [crescentic] glomerulonephritis
- Darkfield microscopy
-
Treponemes
(Syphilis) - Dimorphic yeast sperules with endospores
- Coccidioides immitis
- Dohle bodies : dilated endoplasmic reticulum of PMN, appears as gray cytoplasmic inclusion
- acute inflammation
-
Dx:
Donovan bodies - organism ladden histiocytes - Granuloma Inguinale
- Epitheloid cells : epithelial looking cells on H&E
- activated macrophages as in granulomas
- Ferruginous bodies in lung
- Asbestosis
- Flea bitten kidney
- Malignant HTN
-
Fried egg look
(2) -
- Mycoplasma pneumoniae
- Oligodendroglioma - Fruiting bodies and 45 degree branching septate hyphae
- Aspergillus
- Crinkled paper-looking cell with enlarged cytoplasm
- Gaucher's disease
- Ground glass nuclei
- Papillary CA of thyroid
- Heavily encapsulated yeast
- Cryptococcus neoformans
- Heinz bodies : denatured hemoglobin
- G6PDH deficiency
- Helmet cell : deformed RBC
- TTP
-
Hemolysis - alpha incomplete /green
(2) -
Strep. Pneumoniae;
Viridians strep -
Hemolysis - beta complete /clear
(3) -
Strep. pyogenes;
Staph aureus;
Listeria - Hemolysis - gamma none
- Enterococcus
- Hemolysis - double zone
- Clostridium perfringens
- Hirano bodies : intracytoplasmic actin inclusions (eosinophilic rods)
- Alzheimer's
- Homer Wright rosettes : "small cells" surrounded by fibrillary processes
- Neuroblastoma
-
Howell Jolly cells : RBCs w nuclear remnants
(2) -
- Splenectomy
- Hgb SS -
Hydatid sand :
broad capsule full of silicates -
Echinococcosis
(sheep herder's disease) - Hypochromic Microcytic RBCs
- iron deficiency anemia
- Ito cell : stores vitamin A
- Causes fibrosis of liver -> cirrhosis
- Joint mice
- Osteoarthritis
- Keratin pearls
- Squamous cell carcinoma
- Kimmelstein-Wilson lesions : pink peripheral nodules of glomeruli
- diabetic nephropathy
- Koilocytes : expanded epithelial cells with perinuclear clearing
- HPV
- Lewy bodies : eosinophillic inclusions of ubiquinated neurofilaments in substantia nigra cells
- Parkinson's
- Lines of Zahn
- arterial thrombus
- Lumpy-bumpy IF glomeruli
- poststreptococcal glomerulonephritis
- Mallory bodies : intracytoplasmic eosinophillic inclusions of ubiquinated keraitn intermediate filaments
- Alcoholic hepatitis
- Masson bodies : clumps of Mac digested debris from lung
- Bacterial pneumonia
- Media - Bordet Gengou agar
- bordetella pertussis
- Media - Buffered charcoal yeast extract
- legionella pneumophila
- Media - charcoal blood agar with cephalexin
- bordetella pertussis
- Media - chocolate agar w/ V, X
- H. influenza
- Media - Eaton's agar
- Mycoplasma pneumoniae
- Media - EMB metallic green sheen
- Escherichia coli
- Media - Lowenstein-Jensen media
- mycobacterium tuberculosis
-
Media - MacConkey [pink colonies]
(3) -
MacConKEE:
- Klebsiella
- E.coli
- Enterobacter - Media - Mannitol salt agar
- Staph aureus [ferments]from other staph
- Media - Thayer-Martin chocolate agar
- Neisseria
-
Bug:
Metachromatic granules - Corynebacteria diptheria
- Motility on wet prep pear-shaped organisms
- Trichomonas
- Motility, Swarming
- Proteus mirabilis
- Motility, Tumbling
- Listeria
-
Bug:
Mucoid capsule - Klebsiella
- Multinucleated squamous cells w intranuclear inclusion
- HSV
- Negri bodies : eosinophilic, cytoplasmic inclusions in neurons
- Rabies
- Neuritic plaques
- Alzheimer's
- Neurofibrillary tangles : intracytoplasmic microtubule inclusions
- Alzheimer's
- Nissl bodies
- rough ER [in neurons]
- Nutmeg liver
- Congestive Heart Failure
- Orphan Annie nuclei : hypochromatic nuclei
- Papillary carcinoma of thyroid
- Owl's eye cardiac myocytes in cross section
- Rheumatic fever
- Owl's eye inclusions : nuclear inclusion surrounded by a halo
- CMV
- Peripheral Blood Smear - clock face chromatin
- Plasma cell
- Peripheral Blood Smear - frosted glass cytoplasm w/ kidney shaped nucleus
- Monocyte
-
normal Peripheral Blood Smear - cells w/ granules & bilobate nucleus
(2) -
- Basophil
- Eosinophil - Peripheral Blood Smear - Hypersegmented neutrophils
- Megaloblastic anemia; B12 or folate deficiency
- Peripheral Blood Smear - scant cytoplasm w/ round dense nucleus
- Lymphocyte
- round intracytoplasmic inclusions of neurofilaments
- Pick's disease
-
Pigment - bilirubin
(3) -
- Hemolytic anemia
- Hepatitis
- Gall stones -
Pigment - Hemosiderin
(3) -
- Hematochromatosis
- Left heart failure
- Anemia of chronic disease - Pigment - lipofuscin
- Yellow-brown granular pigment of "wear-n-tear".
-
Pigment - Melanin
(2) -
- ACTH overproduction (Addison's)
- Malignant melanoma. - Polygonal clear cells
- Renal cell carcinoma
-
Psammoma bodies : calcified necrotic tumor cells
(3) -
- Papillary CA
- Meningioma
- Mesothelioma - Pseudopalisades
- Glioblastoma multiforme
- Red inclusions in endocervical cells
- Chlamydia
- Red snappers on acid fast staining
- Tuberculosis
- Reed-Sternberg cells : binucleat cells w prominate inclusion like nucleoli
- Hodgkin's Disease
- Reid Index [increased]
- chronic bronchitis
- Reinke crystals in GU tissue
- Leydig cell tumor
- Rouleaux formation : RBCs stacked as poker chips
- Multiple Myeloma
- Schiller Duval bodies : papillary infoldings into cysts in GU tissue
- Yolk sac tumor
- Schistocyte
- TTP
-
Signet ring cells : mucinous tumor cell
(2) -
- Stomach cancer
- Ovarian mets from stomach tumor (Krukenberd tumor) - Smudge cell : fragile lymphocyte disrupted during slide prep.
- CLL
- Spaghetti and meatballs
- Malassezia furfur
- Spike and Dome IF glomeruli
- Membranous glomerulonephritis
-
Spindle cells
(4) -
Spin the F**** LOG!
- Fibrosarcoma
- Leiomyoma (fibroid)
- Osteosarcoma
- Giant cell tumor of bone -
Spores
(3) -
c.Perfringes,
Anthrax,
Tetani
(and fungi) - Stains - Ziehl-Neelsen
-
Mycobacteria
(Acid-fast bacteria) -
Stains - Giemsa
(4) -
- Trypanosomes
- Borrelia
- Plasmodium
- Chlamydia
(chromosome karyotyping) - Stains - India Ink
- Cryptococcus neoformans
- Starry sky
- Burkitt's lymphoma [EBV]
- Stomatocytes : RBCs w mouth
- Alcoholism
-
Bug:
Sulfur granules - Actinomycosis [A. israelii]
-
Tear drop cells : mis-shapen RBCs
(2) -
- Thalassemias
- Myelofibrosis -
Target cells: bullseye
(2) -
- Alcoholic Liver disease
- Thalassemias -
Tennis rackets
(1 disease, 1 bug) -
- Histiocytosis X
- Clostridium tetani - Tram-Track IF glomeruli
- Membranoproliferative glomerulonephritis
- Warthin-Finkeldey Giant cells
- Measles
- WBC casts
- pyelonephritis
- Weibel Palade bodies : granules contain vWF, adhesion molecules
- nml in endothelial cells
- Wire Loop IF glomeruli
- Lupus nephropathy, type IV
- Yeast w/ capsular halo
- Cryptococcus neoformans
-
Stain - Silver
(3) -
- Fungi
- PCP
- Legionella -
Obligate intracellular bugs
(2) -
- Rickettsia
- Chlamydia
(stay inside when its Really Cold) -
Lactose fermenting
(3) -
Lactose is the KEE
- Klebsiella
- E. coli
- Enterobacter -
RBC casts
(4) -
MING casts a red sky...
- Malignant HTN
- Ischemia
- Nephritic syndromes
- Glomerular inflammation - Granular casts
- Acute Tubular Necrosis
- Waxy casts
- Advanced renal disease (CRF)
- RBCs in urine
- Bladder cancer
- WBCs in urine
- Acute cystitis
- Kidney has split basement membrane
- Alport's syndrome
- Rectal polyp w/ glands & sawtooth crypts
-
Hyperplastic Polyp
(normal--benign) - Buffered charcoal yeast extract
- Legionella
- Heterophile Ab test
- EBV
- Branch hyphae w/ rosettes of conidia
- Sporothrix
- Branch septate hyphae w/ athroconidia
- Tinea pedis
- KOH prep
- mold hyphae
- Short, curved hyphae w/ round yeast
-
Malassezia furfur
(Tinea vesicolor)