Classic Findings/Labs Flashcards
1
Q
High AFP in amniotic fluid or maternal serum
A
Dating error
NTD
2
Q
Anticentromere antibodies
A
Scleroderma (CREST)
3
Q
Anti-desmoglein (anti-desmosome) antibodies
A
Pemphigus vulgaris (blistering)
4
Q
Anti-glomerular basement membrane antibodies
A
Goodpastures syndrome (glomerulonephritis and hemoptysis)
5
Q
Anti-histone antibodies
A
Drug-induced SLE
hydralazine, Isoniazid, phenytoin, proncainamide
6
Q
Anti IgG antibodies
A
Rheumatoid arthritis (systemic inflammation, joint pannus, boutonniere deformity)
7
Q
anti-mitochondrial antibodies (AMA)
A
Primary biliary cirrhosis (female, cholestasis, portal hypertension)
8
Q
Antineutrophil cytoplasmic antibodies (ANCA)
A
Microscopic polyangitis and eosinophilic granulomatosis with polyangiitis (MPO-ANCA/p-ANCA)
Granulomatosis with polyangiitis (Wegner; PR3-ANCA/c-ANCA)
Primary sclerosing cholangitis (MPO-ANCA/p-ANCA)
9
Q
Antinuclear antibodies (ANA)
A
SLE (type III hypersensitivity)
10
Q
Antiplatelet antibodies
A
idiopathic thrombocytopenic purpura
11
Q
Anti-topoisomerase antibodies
A
Diffuse systemic scleroderma
12
Q
Anti-transglutaminase Abs
Anti-gliadin Abs
Anti-endomysial Abs
A
Celiac disease (diarrhea, weight loss)
13
Q
Apple core lesion on barium enema X-rayu
A
Colorectal cancer (usually left-sided)
14
Q
Atypical lymphocytes
A
EBV
15
Q
Azurophilic peroxidase + granular inclusions in granulocytes and myeloblasts
A
Auer rods (AML, especially the promyelocytic M3 type)
16
Q
Bacitracin response
A
Sensitive: S. pyogenes
Resistant: S. agalactiae
17
Q
“Bamboo spine” on xray
A
Ankylosing spondylitis (chronic inflammatory arthritis HLA-B27)
18
Q
Basophilic nuclear remnants in RBCs
A
Howell-Jolly bodies (due to splenectomy or nonfunctional spleen)
19
Q
Bloody or yellow tap on LP
A
Subarachnoid hemorrhage
20
Q
Basophilic stippling of RBC
A
Lead poisoning or sideroblastic anemia
21
Q
“Boot-shaped” heart on x-ray
A
Tetralogy of fallot (due to RVH)
22
Q
Branching Gram + rods with sulfur granules
A
Actinomyces israelii
23
Q
Bronchogenic apical lung tumor on imaging
A
Pancoast tumor
can compress cervical sympathetic chain and cause Horner syndrome
24
Q
“Brown” tumor of bone
A
hyperparathyroidism or osteitis fibrosa cystica (deposited hemosiderin from hemorrhage gives brown color)
25
Cardiomegaly with apical atrophy
Chagas disease (trypanosoma cruzi)
26
Cellular crescents in Bowman's capsule
Rapidly progressing crescentic glomerulonephritis
27
"Chocolate cyst" of the ovary
Endometriosis (frequently involved both ovaries)
28
Circular grouping of dark tumor cells surrounding pail neurofibrils
Homer-wright rosettes (neuroblastoma, medulloblastoma)
29
Colonies of mucoid Pseudomonas in lungs
Cystic fibrosis (autosomal recessive mutation in CFTR gene -> fat soluble vitamin deficiency and mucus plugs)
30
Decreased AFP in Amniotic fluid/maternal syndrome
Down syndrome or other chr abnl
31
Degeneration of dorsal column fibers
```
Tabes dorsalis (tertiary syphilis) or
subacute combined degeneration
```
32
"Delta wave" on EKG
Short PR interval
Supraventricular tachycardia
Wolff-Parkinson-White Syndrome (bundle of kent byasses AV node)
33
Depigmentation of neurons in substantia nigra
Parkinson's disease (basal ganglia disorder, rigidity, resting tremor, bradykinesia)
34
Desquamated epithelium casts in sputum
Curschmann spirals (bronchial asthma; can result in whorled mucous plugs)
35
Disarrayed granulosa cells arranged around collections of eosinophilic liquid
Call-Exner bodies (granulosa cells tumor of the ovary)
36
Dysplastic squamous cervical cells with "raisinoid" nuclei and hyperchormasia
Koilocytes (HPV; predisposes to cervical cancer)
37
Electrical alternans (alternating amplitude on EKG)
Pericardial tamponade
38
Enlarged cells with intranuclear inclusion bodies
"owl eye" appearance of CMV
39
Enlarged thyroid cells with ground glass nuclei with central clearing
"orphan annie" eyes nuclei (papillary carcinoma of the thyroid)
40
Eosinophilic cytoplasmic inclusions in liver cells
Mallory body (alcoholic liver disease)
41
Eosinophilic cytoplasmic inclusions in neuron
Lewy body (Parkinson disease and Lewy body dementia)
42
Eosinophilic globule in liver
```
Councilman body (viral hepatitis, yellow fever)
Represents hepatocyte undergoing apoptosis
```
43
Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar neurons
Negri bodies of rabies
44
Extracellular amyloid deposition in gray matter of brain
Alzheimer's disease
45
Giant B cells with bi-lobed nuclei with prominent inclusions (Owl eye)
Reed-Sternburg cells (Hodgkin lymphoma)
46
Glomerulus-like structure surrounding vessel in germ cells
Schiller-Duval bodies (yolk sac tumor)
47
"Hair on end" (crew cut) appearance on x ray
Beta thalassemia
Sick cell disease
(marrow expansion)
48
hCG elevated
Choriocarcinoma
hydatidiform mole
Multiple pregnancy
49
Heart nodules (granulomatous)
Aschoff bodies (rheumatic fever)
50
Heterophile antibodies
Infectious mononucleosis (EBV)
51
Hexagonal, double-pointed, needle-like crystals in bronchial secretions
Bronchial asthma (charcot-leyden crystals; eosinophilic granules)
52
High level of D-Dimbers
DVT, PE, DIC
53
Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Ghon complex (primary TB)
54
"honeycomb lung" on x-ray or CT
interstitial pulmonary fibrosis
55
hypercoagulability (migrating DVT and vasculitis)
trousseau syndrome (adenocarcinoma of pancreas or lung)
56
hypersegmented neutrophils
```
Megaloblastic anemia
(B12 deficiency: neuro symptoms)
(Folate deficiency: no neuro symptoms)
```
57
hypertension
hypokalemia
metabolic alkalosis
Primary hyperaldosteronism (Conn syndrome)
58
Hypochromic microcytic anemia
Iron deficient anemia
Lead poisoning
Thalassemia
59
Intranuclear eosinophilic droplet-ilke bodies
Cowdry type A bodies (HSV or VZV)
60
Iron-containing nodules in alveolar septum
Ferruginous bodies (asbestosis, increased risk of cancer)
61
Keratin pearls on skin biopsy
Squamous cell carcinoma
62
Large granules in phagocytes
| Immunodeficiency
Chediak-Higashi disease (congenital failure of phagolysosome formation)
63
"lead pipe" appearance of colon on abdominal imaging
Ulcerative colitis (loss of haustra)
64
Linear appearance of IgG deposition on glomerular and alveolar basement membrane
goodpasture syndrome
65
Low serum ceruloplasmin
Wilson disease (hepatolenticular degeneration)
66
Lumpy bumpy appearance of glomeruli on immunofluorescence
Post-strep glomerulonephritis (due to deposition of IgG, IgM, and C3)
67
Lytic "punched-out" bone lesion on x-ray
Multiple myeloma
68
Mammary gland "blue domed" cyst
Fibrocystic change of the breast
69
Monoclonal antibody spike
Multiple myeloma (IgG or IgA)
Monoclonal gammopathy of undetermined significance (MGUS, consequence of aging)
Waldenstrom (IgM)
Primary amyloidosis
70
Mucin-filled cells with peripheral nucleus
"signet ring" of gastric carcinoma
71
Narrowing of bowel lumen on barium x-ray
"string sign" Crohn disease
72
Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis
Granulomatosis with polyangitis (Wegner; PR3-ANCA/c-ANCA)
Goodpasture syndrome (anti-basement membrane abs)
73
Needle shaped, negative biferingent crystals
gout (monosodium urate crystals)
74
Nodular hyaline deposits in glomeruli
`Kimmelstiel-Wison nodules (diabetic neuropathy)
75
Novobiocin response
S. epidermidis (sensitive)
| S. saptrophicus (resistant)
76
"nutmeg" liver
chronic passive congestion of liver due to right sided heart failure or Budd-Chiari syndrome
77
"onion skin" periosteal reaction
Ewing sarcoma (malignant blue cell tumor)
78
Optochin sensitivity
S. pneumo (sensitive)
| S. viridans (resistant): mutans and sanguis
79
Podocyte fusion or "effacement" on electron microscopy
minimal change disease (child with nephrotic syndrome)
80
Protein aggregates in neurons from hyperphosphorylation of tau proteins
neurofibrillary tangles (alzheimer's diseae) and Pick bodies (pick disease)
81
Psamomma bodies
Meningiomas
Papillary thyroid carcinoma
Mesothelioma
Papillary serious carcinoma (endometrium and ovary)
82
Pseudopalisading tumor cells on brain biopsy
gioblastoma multiforme
83
Raised periosteum creating a "codman triangle"
Aggressive bone lesion (osteosarcoma, Ewin sarcoma, osteomyelitis)
84
RBC casts in the urine
Glomerulonephritis
85
Rectangular, crystal-line, cytoplasmic inclusions in leydig cells
Reinke crystals (Leydig cell tumor)
86
Renal epithelial casts in urine
Intrinsic renal failure (ischemia or toxic injury)
87
Recurrent infections
eczema
Thrombocytopenia
Wiskott-Aldrich syndrome
88
Rhomboid crystals
| + bifiringence
Psuedogout (calcium pyrophosphate dihydrate crystals)
89
Rib notching (inferior surface) on xray
Coarctation of the aorta
90
Ring-enhancing brain lesion on CT
toxoplasma gondii
| CNS lymphoma
91
Sheets of medium-sized lymphoid cells with scattered pale, tingible body-laden macrophages (starry sky)
Burkitt lymphoma (t[8:14], c-myc activation)
Associated with EBV
92
Silver-staining spherical aggregation of tau protein in neurons
pick bodies (pick disease, progressive dementia, changes in personality)
93
"Soap bubble" in femur or tibia on xray
giant cell tumor of bone
94
"spikes" on basement membrane
| "dome-like" subepithelial deposits
Membranous nephropathy (nephrotic syndrome)
95
Stacks of RBC
Rouleaux formation (high ESR, multiple myeloma)
96
"steeple" sign on frontal CXR
Croup (parainfluenza virus)
97
Bacteria-covered vaginal epithelial cells
"Clue cells" Gardenella vaginalis
98
Streptococcus bovis bacteremia
Colon cancer
99
"Tennis racket"-shaped cytoplasmic organelles in langerhans cells
Birbeck granules (Langerhans cell histiocytosis)
100
Thousands of polys on colonoscopy
FAP (AD mutation of APC gene)
101
Thrombi made of red/white layers
Lines of Zahn (arterial thrombus, layers of platelets and RBC)
102
"thumb sign" on lateral neck x-ray
Epiglottitis (Haemophilis influenzae)
103
Thyroid-like appearance of kidney
Chronic pyelonephritis
104
"Tram-track" appearance of capillary loops of glomerular basement membrane on light microscopy
Membranoproliferative glomerulonephritis
105
Triglyceride accumulation in liver cell vacuoles
Fatty liver disease (alcoholic or metabolic)
106
High uric acid levels
gout, lesch-nyhan, tumor lysis syndrome, loop and thiazide diuretics
107
"waxy" casts with low urine flow
chronic end-stage renal disease
108
WBC casts in urine
Acute pyelonephrtitis
109
WBC that look "smudged"
CLL (almost always B cells)
110
Wire loops glomerular capillary appearance
Diffuse proliferative glomerulonepthritis (seen with SLE)
111
Yellowish CSF
Xanthochromia due to subarachnoid hemorrhage
