Classic Lab/Diagnostic Findings (First Aid Rapid Review) Flashcards
Anti-centromere antibodies
Scleroderma
CREST
Antidesmoglein (epithelial) antibodies
Pemphigus vulgaris
Blistering
Anti-glomerular basement membrane antibodies
Goodpasture syndrome
Glomerulonephritis and hemoptysis
Antihistone antibodies
Drug-induced SLE
Hydralazine, INH, Phenytoin, Procainamide
Anti-IgG antibodies
Rheumatoid arthritis (Systemic inflammation, joint pannus, boutonniere deformity)
Antimitochondrial antibodies (AMAs)
Primary biliary cirrhosis
Female, cholestasis, portal hypertension
Antineutrophil cytoplasmic antibodies (ANCAs)
Microscopic polyangiitis and Churg-Strauss syndrome (MPO-ANCA/p-ANCA)
Granulomatosis w/ polyangiitis (Wegener; PR3-ANCA/c-ANCA)
Antinuclear antibodies (ANAs: anti-Smith and anti-dsDNA)
SLE
Type III hypersensitivity
Antiplatelet antibodies
Idiopathic thrombocytopenic purpura
Anti-topoisomerase antibodies
Diffuse systemic scleroderma
Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies
Celiac disease
Diarrhea, distension, weight loss
“Apple core” lesion on abdominal x-ray
Colorectal cancer
Usually left-sided
Azurophilic peroxidase (+) Granular inclusions in granulocyte and myeloblasts
Auer rods (AML, especially the promyelocytic [M3] type)
Bacitracin response
Sensitive: Streptococcus pyogenes (Group A)
Resistant: Streptococcus agalactiae (Group B)
“Bamboo spine” on x-ray
Ankylosing spondylitis
Chronic inflammatory arthritis: HLA-B27
Basophilic nuclear remnants in RBCs
Howell-Jolly bodies
Due to splenectomy or nonfunctional spleen
Basophilic stippling of RBCs
Lead poisoning or sideroblastic anemia
Bloody tap on LP
Subarachnoid hemorrhage
“Boot-shaped” heart on x-ray
Tetrology of Fallot
RVH
Branching gram+ rods w/ sulfur granules
Actinomyces israelii
Bronchogenic apical lung tumor on imaging
Pancost tumor
Can compress sympathetic ganglion and cause Horner syndrome
“Brown” tumor of bone
Hyperparathyroidism
or
Osteitis fibrosa cystica
(deposited hemosiderin from hemorrhage gives brown color)
Cardiomegaly w/ apical atrophy
Chagas disease
Trypanosoma cruzi
Cellular cresents in Bowman capsule
Rapidly progressive crescentic glomerulonephritis
“Chocolate cyst” of ovary
Endometriosis
Frequently involves both ovaries
Circular grouping of dark tumor cells surrounding pale neurofibrils
Homer-Wright rosettes
Neuroblastoma, medulloblastoma, retinoblastoma
Colonies of mucoid Pseudomonas in lungs
Cystic fibrosis (Autosomal recessive mutation in CFTR gene --> fat soluble vitamin deficiency and mucous plugs)
Decrease AFP in amniotic fluid/maternal serum
Down syndrome
or
Other chromosomal abnormality
Degeneration of dorsal column nerves
Tabes dorsalis (Tertiary syphillis) Subacute combined degeneration (Dorsal columns and lateral corticospinal tracts affected)
Depigmentation of neurons in substantia nigra
Parkinson disease
Basal ganglia disorder: ridgidity, resting tremor, bradykinesia
Desquamated epithelium casts in sputum
Curschmann spirals
(Bronchial asthma)
(Can result in whorled mucous plugs)
Disarrayed granulosa cells in eosinophilic fluid
Call-Exner bodies
Granulosa-theca cell tumor of the ovary
Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia
Koilocytes
HPV: predisposes to cervical cancer
Enlarged cells with intranuclear inclusion bodies
“Owl eye” appearance of CMV
Enlarged thyroid cells with ground-glass nuclei
“Orphan Annie” eyes nuclei
Papillary carcinoma of the thyroid
Eosinophilic cytoplasmic inclusion in liver cell
Mallory body
Alcoholic liver disease
Eosinophilic cytoplasmic inclusion in nerve cell
Lewy body
Parkinson disease
Eosinophilic globule in liver
Councilman body
Toxic or viral hepatitis, often yellow fever
Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar nerve cells
Negri bodies of rabies
Extracellular amyloid deposition in gray matter of brain
Senile plaques
Alzheimer disease
Giant B cells with bilobed nuclei with prominent inclusions (“owl’s eye”)
Reed-Sternberg cells
Hodgkin lymphoma
Glomerulus-like structure surrounding vessel in germ cell
Schiller-Duval bodies
Yolk sac tumor
“Hair on end” (crew-cut) appearance on x-ray
B-thalassemia
Sickle cell anemia
(Marrow expansion)
hCG elevated
Choriocarcinoma
Hydatiform mole
(occurs w/ and w/o embryo, and multiple pregnancy)
Heart nodules (granulomatous)
Aschoff bodies
rheumatic fever
Heterophile antibodies
Infectious mononucleosis
EBV
Hexagonal, double-pointed, needle-like crystals in bronchial secretions
Bronchial asthma
Charcot-Leyden crystals: eosinophilic granules
High level of D-dimers
DVT
Pulmonary embolism
DIC
Hilar LAD
Peripheral granulomatous lesions in middle or lower lung lobes (can calcify)
Ghon complex
Primary TB: Mycobacterium bacilli
“Honeycomb lung” on x-ray or CT
Interstitial pulmonary fibrosis
Hypercoagulability (leading to migrating DVTs and vasculitis)
Trousseau’s syndrome
Adenocarcinoma of pancreas or lungs
Hypersegmented neutrophils
Megaloblastic anemia (B12 deficiency: neurologic sx) (Folate deficiency: no neurologic sx)
HTN
HYPOkalemia
Metabolic ALKalosis
Conn’s syndrome
Hypochromic, microcytic anemia
Iron deficiency anemia
Lead poisoning
Thalassemia (fetal Hb sometimes present)
Increased alpha-fetoprotein in amniotic fluid/maternal serum
Dating error
Anencephaly
Spina bifida (NT defects)
Increased uric acid levels
Gout
Lesch-Nyhan syndrome
Tumor lysis syndrome
Loop and thiazide diuretics
Intranuclear eosinophilic droplet-like bodies
Cowdry type A bodies
HSV or CMV
Iron-containing nodules in alveolar septum
Ferruginous bodies (Asbestosis: increased chance of mesothelioma)
Keratin pearls on a skin biopsy
Squamous cell carcinoma
Large lysosomal vesicles in phagocytes
Immunodeficiency
Chediak-Higashi disease
Congenital failure of phagolysosome formation
“Lead pipe” appearance of colon on barium enema x-ray
Ulcerative colitis
Loss of haustra
Linear appearance of IgG deposition on glomerular basement membrane
Goodpasture’s syndrome
Low serum ceruloplasmin
Wilson’s disease
Hepatolenticular degeneration
“Lumpy bumpy” appearance of glomeruli on immunofluorescence
Post-streptococcal glomerulonephritis
Immune complex deposition of IgG and C3b
Lytic (“hole punched”) bone lesions on x-ray
Multiple myeloma
Mammary gland (“blue domed”) cyst
Fibrocystic change of breast
Monoclonal antibody spike
Multiple myeloma (usually IgG or IgA) Monoclonal gammopathy of undetermined significance (MGUS; normal consequence of aging) Waldenstrom's (M protein=IgM) macroglobulinemia Primary amyloidosis
Mucin-filled cell w/ peripheral nucleus
Signet ring
Gastric carcinoma
Narrowing of bowel lumen on barium x-ray
“String sign”
Crohn’s disease
Necrotizing vasculitis (lungs)
and
Necrotizing glomerulonephritis
Granulomatosis w/ polyangiitis (Wegener’s; (+) c-ANCA)
Goodpasture’s syndrome (anti-basement membrane antibodies)
Needle-shaped
Negatively birefringent crystals
Gout
Monosodium urate crystals
Nodular hyaline deposits in glomeruli
Kimmelstiel-Wilson nodules
Diabetic nephropathy
Novobiocin response
Sensitive: Staphlococcus epidermidis
Resistant: Staphlococcus saprophyticus
“Nutmeg” appearance of liver
Chronic passive congestion of liver due to RH failure
“Onion skin” periosteal reaction
Ewing’s sarcoma
Malignant round-cell tumor
Optochin response
Sensitive: Streptococcus pneumoniae
Resistant: Viridans streptococcus
Periosteum raised from bone, creating triangular area
Codman’s triangle on x-ray
Osteosarcoma, Ewing’s sarcoma, pyogenic osteomyelitis
Podocyte fusion or “effacement” on electron microscopy
Minimal change disease
Child w/ nephrotic syndrome
Polished, “ivory like” appearance of bone at cartilage erosion
Eburnation
Osteoarthritis resulting in bone sclerosis
Protein aggregates in neurons from hyperphosphorylation of protein tau
Neurofibrillary tangles (Alzheimer's disease) Pick's bodies (Pick's disease)
Psammoma bodies
Meningiomas
Papillary thyroid carcinoma
Mesothelioma
Papillary serous carcinoma of endometrium and ovary
Pseudopalisading tumor cells on brain biopsy
Glioblastoma multiforme
RBC casts in urine
Acute glomerulonephritis
Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells
Reinke crystals
Leydig cell tumor
Renal epithelial casts in urine
Acute toxic/viral nephrosis
Rhomboid crystals
Positively birefringent
Pseudogout
Calcium pyrophosphate dihydrate crystals
Rib notching
Coarctation of the aorta
Ring-enhancing brain lesions in AIDS
Toxoplasma gondii
CNS lymphoma
Sheets of medium-sized lymphoid cells with scattered pale, tingible body-laden macrophages
(“Starry sky” histology)
Burkitt’s lymphoma
t[8:14] c-myc activation, associated with EBV; “black sky” made up of malignant cells
Silver-staining spherical aggregation of tau proteins in neurons
Pick bodies (Pick's disease: progressive dementia, changes in personality)
“Soap bubble” in femur or tibia on x-ray
Giant cell tumor of bone
Generally benign
“Spikes” on basement membrane
“Dome like” subepithelial deposits
Membranous glomerulonephritis
May progress to nephrotic syndrome
Stacks of RBCs
Rouleaux formation
High ESR, multiple myeloma
Stippled vaginal epithelial cells
“Clue cells”
Gardnerella vaginalis
“Tennis racket” shaped cytoplasmic organelles (EM) in Langerhans cells
Birbeck granules
(Langerhans cell histiocytosis
or histiocytosis X: eosinophlic granuloma)
Thrombi made of white/red layers
Lines of Zahn
Arterial thrombus, layers of platelets/RBCs
“Thumb sign” on lateral x-ray
Epiglotittis
Haemophilus influenzae
Thyroid-like appearance of kidney
Chronic bacterial pyelonephritis
Tram-track appearance of capillary loops of glomerular basement membranes on light microscopy
Membranoproliferative glomerulonephritis
Triglyceride accumulation in liver cell vacuoles
Fatty liver disease
Alcoholic or metabolic syndrome
“Waxy” casts with very low urine flow
Chronic end-stage renal disease
WBC casts in urine
Acute pyelonephritis
WBCs that look “smudged”
CLL
Almost always B cell
“Wire loop” glomerular capillary appearance on light microscopy
Lupus nephritis
Yellowish CSF
Xanthochromia
e.g. due to subarachnoid hemorrhage