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COMLEX 2 > Classic Lab/Diagnostic Findings > Flashcards

Classic Lab/Diagnostic Findings Flashcards

1
Q

decrease AFP in amniotic fluid/maternal serum

A

down syndrome or other chromosomal abnormlaities

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2
Q

large granules in phagocytes, immunodeficiency

A

Chediak-Higashi disease (congenital failure of phagolysosome formation)

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3
Q

recurrent infections, eczema, thrombocytopenia

A

Wiskott-Aldrich syndrome

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4
Q

branching gram + rods with sulfur granules

A

actinomyces israelii

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5
Q

optochin sensitivity

A

sensitive: S. pneumoniae;
resistant: viridian’s streptococci (S mutans, S sanguis)

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6
Q

novobiocin response

A

sensitive: S epidermidis
resistant: S saprophyticus

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7
Q

bacitracin response

A

sensitive: S pyogenes (group A)
resistant: S agalactiae (group B)

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8
Q

streptococcus bovid bacteremia

A

colon cancer

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9
Q

hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobs (can calcify)

A

Ghon complex (primary TB: mycobacterium bacilli)

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10
Q

bacteria-covered vaginal epithelial cells

A

‘clue cells’

gardnerella vaginalis

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11
Q

ring-enhancing brain lesion on CT/MRI in AIDS

A

toxoplasma gondii

CNS lymphoma

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12
Q

cardiomegaly with apical atrophy

A

Chagas disease (trypanosome cruzi)

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13
Q

heterophiles antibodies

A

infectious mononucleosis (EBV)

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14
Q

intranuclear eosinophilic droplet-like bodies

A

Cowdry type A bodies (HSV or VZV)

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15
Q

eosinophilic globule in liver

A 
councilman body (viral hepatitis, yellow fever)
represents hepatocyte undergoing apoptosis
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16
Q

‘steeple’ sign on frontal CXR

A

croup (parainfluenza virus)

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17
Q

eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar neurons

A

Negri bodies of rabies

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18
Q

atypical lymphocytes

A

EBV

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19
Q

enlarged cells with intranuclear inclusion bodies

A

‘owl eye’ appearance of CMV

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20
Q

‘thumb sign’ on lateral neck xray

A

epiglottitis (haemophilus influenzae)

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21
Q

‘delta wave’ on EKG, short PR interval, supra ventricular tachycardia

A

Wolff-Parkinson-White syndrome (Bundle of Kent bypasses AV node)

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22
Q

‘boot-shaped’ heart on xray

A

tetralogy of fallot (due to RVH)

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23
Q

rib notching (inferior surface, on xray)

A

coarctation of aorta

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24
Q

heart nodules (granulomatous)

A

Aschoff bodies (rheumatic fever)

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25
Q

electrical alternans (alternating amplitude on EKG)

A

pericardial tamponade

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26
Q

hypertension, hypokalemia, metabolic alkalosis

A

primary hyperaldosteronism (Conn syndrome)

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27
Q

enlarged thyroid cells with ground-glass nuclei with central clearing

A

“orphan Annie” eyes nuclei (papillary carcinoma of the thyroid)

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28
Q

antineutrophil cytoplasmic antibodies (ANCAs)

A 
p-ANCA/MPO-ANCA = microscopic polyangiitis and eosinophilic granulomatosis with polyangiitis, primary sclerosing cholangitis
c-ANCA/PR3-ANCA = Wegener; granulomatosis with polyangiitis
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29
Q

mucin-filled cell with peripheral nucleus

A

‘signet ring’ (gastric carcinoma)

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30
Q

anti-transglutaminase/anti-gliadin/anti-endomysial antibodies

A

celiac disease (diarrhea, weight loss)

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31
Q

narrowing of bowel lumen on barium xray

A

‘string sign’ (Crohn disease)

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32
Q

‘lead pipe’ appearance of colon on abdominal imaging

A

ulcerative colitis (loss of haustra)

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33
Q

thousands of polyps on colonoscopy

A

familial adenomatous polyposis (autosomal dominant, mutation of APC gene)

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34
Q

‘apple core’ lesion on barium enema xray

A

colorectal cancer (usually left-sided)

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35
Q

eosinophilic cytoplasmic inclusion in liver cell

A

mallory body (alcoholic liver disease)

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36
Q

triglyceride accumulation in liver cell vacuoles

A

fatty liver disease (alcoholic or metabolic syndrome)

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37
Q

‘nutmeg’ appearance of liver

A

chronic passive congestion of liver due to right heart failure or Budd-Chiari syndrome

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38
Q

antimitochondrial antibodies (AMAs)

A

primary biliary cirrhosis (female, cholestasis, portal hypertension)

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39
Q

low serum ceruloplasmin

A

Wilson disease (hepatolenticular degeneration; Kayser-Fleischer rings d/t copper accumulation)

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40
Q

migratory thrombophlebitis (leading to migrating DVTs and vasculitis)

A

Trousseau syndrome (adenocarcinoma of pancreas or lung)

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41
Q

basophilic nuclear remnants in RBCs

A

Howell-Jolly bodies (d/t splenectomy or nonfunctional spleen)

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42
Q

hypochromic, microcytic anemia

A

iron deficiency anemia, lead poisoning, thalassemia (fetal hemoglobin sometimes present)

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43
Q

basophilic stippling of RBCs

A

lead poisoning or sideroblastic anemia

44
Q

‘hair on end’ (crew-cut’) appearance on xray

A

ß-thalassemia, sickle cell disease (marrow expansion)

45
Q

hyperhsegmented neutrophils

A

megaloblastic anemia (B12 deficiency: neurologic symptoms; folate deficiency: no neurologic symptoms)

46
Q

anti platelet antibodies

A

idiopathic thrombocytopenia purpura

47
Q

high level of D-dimers

A

DVT, PE, DIC

48
Q

Giant B cells with bilobed nuclei with prominent inclusions (‘owl’s eye’)

A

Reed-Sternberg cells (Hodgkin lymphoma)

49
Q

sheets of medium-sized lymphoid cells with scattered pale, tingible body-laden macrophages (‘starry sky’ histology)

A

Burkitt lymphoma (t(18;14) c-myc activation, associate with EBV, ‘starry sky’ made up of malignant cells)

50
Q

lytic ‘punched out’ bone lesions on xray

A

multiple myeloma

51
Q

monoclonal antibody spike

A
  • multiple myeloma (usually IgG or IgA)
  • monoclonal gammopathy of undetermined significance (MGUS consequence of aging)
  • Waldenstrom (M protein = IgM) macroglobulinemia
  • primary amyloidosis
52
Q

stacks of RBCs

A

rouleaux formation (high ESR, multiple myeloma)

53
Q

azurophilic peroxidase + granular inclusions in granulocytes and myeloblasts

A

Auer rods (AML, especially the promyelocytic [M3] type)

54
Q

WBCs that look ‘smudged’

A

CLL (almost always B cell)

55
Q

‘tennis racket’ shaped cytoplasmic organelles (EM in langerhans cells

A

birbeck granules (langerhans cell histiocytosis)

56
Q

‘brown’ tumor of bone

A

hyperparathyroidism or osteitis fibrosa cystica (deposits of hemosiderin from hemorrhage gives brown color)

57
Q

raised periosteum (creating a ‘codman triangle’)

A

aggressive bone lesion (osteosarcoma, Ewing sarcoma, osteomyelitis)

58
Q

‘soap bubble’ in femur or tibia on xray

A

giant cell tumor of bone (generally benign)

59
Q

‘onion skin’ periosteal reaction

A

Ewing sarcoma (malignant small blue cell tumor)

60
Q

Anti-IgG antibodies

A

Rheumatoid arthritis (systemic inflammation, joint pannus, boutonniere and swan neck deformities)

61
Q

rhomboid crystals, + birefringent

A

psueodgout (calcium pyrophosphate dehydrate crystals)

62
Q

needle-shaped - birefringent crystals

A

gout (monosodium urate crystals)

63
Q

increase uric acid levels

A

gout, lesch-nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics

64
Q

‘bamboo spine’ on xray

A

ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27)

65
Q

antinuclear antibodies (ANAs: anti-Smith and anti-dsDNA)

A

SLE (type III hypersensitivity = immune complexes)

66
Q

anti-topoisomerase antibodies

A

diffuse systemic scleroderma

67
Q

keratin pearls on skin biopsy

A

squamous cell carcinoma

68
Q

antihistone antibodies

A

drug-induced SLE (e.g. hydralazine, isoniazid, phenytoin, procainamide)

69
Q

bloody or yellow tap on LP

A

SAH

70
Q

yellowish CSF

A

xanthochromia (d/t SAH)

71
Q

eosinophilic cytoplasmic inclusion in neuron

A

Lewy body (Parkinson disease and lewy body dementia)

72
Q

extracellular amyloid deposition in gray matter of brain

A

senile plaques (Alzheimer disease)

73
Q

depigmentation of neurons in substantia nigra

A

Parkinson disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia)

74
Q

protein aggregates in neurons from hyperphosphorylation of τ protein

A

neurofibrillary tangles (Alzheimer disease) and Pick bodies (Pick disease)

75
Q

silver-staining spherical aggregation of τ proteins in neurons

A

Pick bodies (Pick disease: progressive dementia, change in personality)

76
Q

pseudopalisading tumor cells on brain biopsy

A

glioblastoma multiforme

77
Q

circular grouping of dark tumor cells surrounding pale neurofibrils

A

Homer-Wright rosettes (neuroblastoma, medulloblastoma)

78
Q

‘waxy’ casts with very low urine flow

A

chronic end stage renal disease

79
Q

RBC casts in urine

A

glomerulonephritis

80
Q

‘tram-track’ appearance of capillary loops of glomerular basement membranes on light microscopy

A

membranoproliferative glomerulonephritis

81
Q

nodular hyaline deposits in glomeruli

A

Kimmelstiel-Wilson nodules (diabetic nephropathy)

82
Q

podocyte fusion or ‘effacement’ on electron microscopy

A

minimal change disease (child with nephrotic syndrome)

83
Q

‘spikes’ on basement membrane, ‘dome-like’ sub epithelial deposits

A

membranous nephropathy (nephrotic syndrome)

84
Q

anti-glomerular basement membrane antibodies

A

Goodpasture syndrome (glomerulonephritis and hemoptysis)

85
Q

cellular crescents in Bowman capsule

A

rapidly progressive crescentic glomerulonephritis

86
Q

‘wire loop’ glomerular capillary appearance on light microscopy

A

diffuse proliferative glomerulonephritis (usually seen with lupus)

87
Q

linear appearance of IgG deposition on glomerular and alveolar basement membranes

A

Goodpasture syndrome

88
Q

‘lumpy bumpy’ appearance of glomeruli on immunofluorescence

A

poststreptococcal glomerulonephritis (due to deposition of IgG, IgM, and C3)

89
Q

necrotizing vasculitis (lungs) and necrotizing glomerulonephritis

A

granulmatosis with polyangiitis (Wegener; PR3-ANCA/c-ANCA) and Goodpasture syndrome (anti-basement membrane antibodies)

90
Q

thyroid-like appearance of kidney

A

chronic pyelonephritis (usually due to recurrent infections)

91
Q

WBC casts in urine

A

acute pyelonephritis

92
Q

renal epithelial casts in urine

A

intrinsic renal failure (e.g. ischemia or toxic injury)

93
Q

ß-hCG elevated

A

choriocarcinoma, hydatidiform mole (occurs with and without embryo, and multiple pregnancy)

94
Q

dysplastic squamous cervical cells with ‘raisinoid’ nuclei and hyperchromasia

A

koilocytes (HPV: predisposes to cervical cancer)

95
Q

psammoma bodies

A

meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinomas of the endometrium and ovary

96
Q

disarrayed granuloma cells arranged around collections of eosinophilic fluid

A

Call-Exner bodies (granuloma cell tumor of the ovary)

97
Q

‘chocolate cyst’ of ovary

A

endometriosis (frequently involves both ovaries)

98
Q

mammary gland (‘blue domed’) cyst

A

fibrocystic change of the breast

99
Q

glomerulus-like structure surrounding vessel in germ cells

A

Schiller-Duval bodies (yolk sac tumor)

100
Q

rectangular, crystal-like, cytoplasmic inclusions in Leydig cells

A

Reinke crystals (Leydig cell tumor)

101
Q

thrombi made of white/red layers

A

lines of Zahn (arterial thrombus, layers of platelets/RBCs)

102
Q

hexagonal, double-pointed, needle-like crystals in bronchial secretions

A

bronchial asthma (Charcot-leyden crystals: eosinophilic granules)

103
Q

desquamated epithelium casts in sputum

A

curschmann spirals (bronchial asthma, can result in whorled mucous plugs)

104
Q

‘honeycomb lung’ on xray or CT

A

interstitial pulmonary fibrosis

105
Q

colonies of mucoid Pseudomonas in lungs

A

cystic fibrosis (autosomal recessive mutation in CFTR gene -> fat-soluble vitamin deficiency and mucous plug)

106
Q

iron-containing nodules in alveolar septum

A

ferruginous bodies (asbestosis: increase chance of lung cancer)

107
Q

bronchogenic apical lung tumor on imaging

A

Pancoast tumor (can compress cervical sympathetic chain and cause Horner syndrome)

COMLEX 2 (37 decks)

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