Classic lab findings Flashcards
1
Q
anticentromere antibodies
A
scleroderma (CREST) (calcinosis, Raynaud phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia)
2
Q
anti-desmoglein (epithelial) antibodies
A
pemphigus vulgaris (blistering) - intraepidermal
3
Q
anti-glomerular bm antibodies
A
goodpasteur syndrome (glomerulonephritis and hemoptysis)
4
Q
anti-histone antibodies
A
drug induced SLE (hydralazine, isoniazid, phenytoin, procainamide)
5
Q
anti-IgG antibodies
A
RA (systemic inflammaiton, joint pannus boutonniere deformity)
6
Q
antimitochondrial antibodies
A
primary biliary cirrhosis (female, cholestasis, hypertension)
7
Q
antineutrophil cytoplasmic antibodies ANCA
A
Microscopic polyangitis and eosinophilic granulomatosis with polyangitis (Churg-strauss syndrome) (MPO-ANCA/p-ANCA); granulomatosis with polyangitis (Wegener; PR3-ANCA/c-ANCA)
8
Q
antinuclear antibodies (ANAs: anti-smith anti-dsDNA)
A
SLE (type III hypersensitivity)
9
Q
antiplatelet antibodies
A
idiopathic thrombocytopenic purpura
10
Q
anti-topoisomerase antibodies
A
diffuse systemic scleroderma
11
Q
anti-transgluatminase / anti-gliadin / anti-endomysial antibodies
A
celiac disease (diarrhea weight loss)
12
Q
apple core lesion on barium enema x ray
A
colorectal cancer (usually left sided)
13
Q
atypical lymphocytes
A
EBV
14
Q
azurophilic peroxidase (+) granular inclusion in granulocytes and myeloblasts
A
auer rods (aml, especially the promyelocytic (m3) type)
15
Q
bacitracin response
A
sensitive: s pyogenes (group a); resistant S. agalactiae (group b)
16
Q
BAMBOO spine on x-ray
A
ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27)
17
Q
Basophilic nuclear remnants in RBCs
A
Howell Jolly bodies (due to splenectomy or nonfunctional spleen)
18
Q
basophilic stippling of RBCs
A
lead poisoning or sideroblastic anemia
19
Q
Bloody or yellow tap on lumbar puncture
A
subarachnoid hemorrhage
20
Q
boot shaped heart on x ray
A
tetralogy of fallot (due to RVH)
21
Q
Tetrology of fallot
A
VS defect
pulmonary stenosis
RVH
Overarching aorta
22
Q
branching gram positive rods with sulfur granules
A
actinomyces israelii (facultative anaerobes)
23
Q
bronchogenic apical lung tumor on imaging
A
pancoast tumor (can compress cervical sympathetic hcain 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 (typanosoma cruzi)
26
cellular crescents in Bowman capsule
rapidly progressive crescentric glomerulonephritis
27
chocolate cyst of ovary
endometriosis (frequent involves both ovaries)
28
circular grouping of dark tumor cells surrounding pale neurofibirls
Horner Wright rosettes (neuroblastoma, medullosblastoma)
29
colonies of mucoid Pseudomonas in lungs
cystic fibrosis - AR CFTR --> fat soluble vitamin deficiency and mucous plugs
30
decreased AFP in amniotic fluid / maternal serum
Down syndrome or other chromosomal anomalies
31
degeneration of dorsal column fibers
tabes dorsalis - tertiary syphillis; subacute combined degernation (dorsal columns, lateral corticospinal, spinocerebellar tracts affected)
32
delta wave on EKG, short PR interval, supraventricular tachycardia
Wolff parkinson white syndrome (bundal of kent bypasses AV node)
33
depigmentation of neurons in substantia nigra
parkinson 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 fluid
call-exner bodes (granulosa cell tumors of the ovary)
36
dysplastic squamous cervical cells with "raisinoid" nucli and hyperchromasia
koilocytes (HPV: predisposes to cervical cancer)
37
electrical alternans (alternating amplitude on ekg)
pericardial temponade
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
eosinophlic cytoplasmic inclusion in liver cell
mallory body - alcoholic liver disease
41
eosinophilic cytoplasmic inclusion in nerve cell
lewy body (parkinson disease)
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
extracelluar amyloid deposition in grey matter of brain
senile plaques (alzheimer disease)
45
giant b cells with bilobed nuclei with prominent inclusions (owls eye)
hodgkins lymphoma (reed sternburg cells)
46
glomerulus like structure surround vessel in germ cells
Schiller duval bodies (yolk sac tumor)
47
Hair on end (crew-cut) appearance on x-ray
b-thalassemia, sickle cell disease (marrow expansion)
48
hCG level elevated
choriocarinoma, hydatidiform mole (occurs with and wihtout embryo, and multiple pregnancy)
49
heart nodules (granulomatous)
aschoff bodies (rheumatic fever)
50
heterophile antibodies
infectious mononucleosis
51
hexagonal, double pointed, needle-like crystals in bronchial secretions
bronchial asthma (charcot-leyden crystals: eosinophilic granules)
52
high level of d-dimers
DVT, PE, DIC
53
hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Ghon complex (primary TB: mycobacterium bacili)
54
honeycomb lung on x-ray or CT
Interstitial pulmonary fibrosis
55
hypercoagulability (leading to migrating DVTs and vasculitis)
Trousseau syndrome (adenocarcinoma of the pancreas or lungs)
56
hypersegmented neutrophils
megaloblastic anemia (b12 defeicency: neuro signals; folate deficiency: no neuro signs)
57
hypertension, hypokalemia, metabolic alkalosis
Conn syndrome (primary hyperalodteronism)
58
hypochromic, microcytic anemia
iron deficiency anemia, lead poisoning, thalassemia (fetal hemoglobin sometimes present)
59
increased AFP in amniotic fluid/maternal serum
dating error, anancephaly, spina bifida, (neural tube defects)
60
increased uric acid levels
gout, lesch-nyhan, tumor lysis syndrome, loop and thiazide diuretics
61
intranuclear eosinophilic droplet like bodies
cowdry type A bodies (HSV or VSV)
62
Iron containing nodules in alveolar septum
ferruginous bodies (abestosis - increases chance of mesothelioma)
63
keratin pearls on a skin biopsy
squamous cell carcinoma
64
large granules in phagocytes, immunodeficiency
Chediak Higashi disease (congenital failure of phagolysosome formation)
65
lead pipe appearance of colon on abdominal imaging
ulcerative colitis - loss of haustra
66
linear appearance of IgG deposition on glomerular and alveolar BM
Goodpasteur
67
low serum ceruloplasmin
wilson disease (hepatolenticular degeneration)
68
lumpy bumpy appearance of glomeruli on immunofluorescence
poststreptococcal glomerulonephritis (due to deposition of IgG, IgM, and C3)
69
Lytic bone (punched out) bone lesion on x-ray
multiple myeloma
70
mammary gland (blue domed cyst)
fibrocystic change of the breast
71
monoclonal antibody spike
multiple myeloma - usually IgG or IgA
monoclonal gammopathy of undeterine significance (MGUS) consequence of aging
waldenstrom (M- ptoein = IgM) macroglobulinemia
Primary amyloidosis
72
mucin filled cell with peripheral nucleus
signet ring (gastric carcinoma)
73
narrowing of bowel lumen on barium x-ray
string sign (chrons)
74
necrotizing vasculitis (lungs) and necrotizing glomerulonephritis
granulomatosis with polyangitis (Wegener, PR3-ANCA/c-ANCA) and Goodpasteur syndrome (anti-basement membrane antibodies)
75
needle shaped negatively birefringent crystals
gout (monosodium urate)
76
nodular hyaline deposits in the glomeruli
kimmelstiel wilson nodules (diabetic neuropathy)
77
novobiocin response
sensitive: s epidermidis
resistent: s. saprophyticus
78
nutmeg liver
chronic passive congestion of liver due to right heart failure or budd-chiari syndrome
79
onion skin periosteal reaction
ewing sarcoma (malignant small blue cell tumor)
80
optochin response
sensitive: s. penumoniae
resistent: viridians streptococci (s. mutans, s. sanguis)
81
podocyte fusion of "effacement" on electron microscopy
minimal change disease (child with nephrotic syndrome)
82
polished "ivory like" appearacne of bone at cartilage erosion
eburnation (osteoarthritis resutling in bony clerosis)
83
protein aggregates in neurons from hyperphosphorylation of tau protein
neruofibrillary tangles (alzheimers disease) and pick bodies (pick disease)
84
psammoma bodies
meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of the endometrium and ovary
85
pseudopalisading tumor cells on brain biopsy
glioblastoma multiform
86
rbc casts in urine
glomerulonephritis
87
rectangular, crystal like, cytoplasmic inclusions in Leydig cells
reinke crystals (leydig cell tumor)
88
recurrent infections, eczema, thromocytopenia
Wiskott aldrich syndrome
89
renal epithelial casts in urine
intrinsic renal failure (ischemia or toxin)
90
rhomboid crystals, positive biofringence
pseudogout (calicum pyrophosphage dihydrate cyrstals)
91
rib notching
coarctation of the aorta
92
ring enhancing brains lesion in aids
toxoplasma gondii, cns lymphoma
93
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 'starry sky" made up of malignant cells
94
silver staining spherical aggregation of tau proteins in neurons
pick bodies (pick disease progressive dementia, changes in personality)
95
soap bubble in femur or tibia on x-ray
giant cell tumor of bone (generally benign)
96
spikes on BM "dome like" subepithelial deposits
Membranous nephropathy (nephrotic syndrome)
97
stacks of RBCs
rouleaux formations (high ESR, multiple myeloma)
98
steeple sign on CXR
Croup (parainfluenza virus)
99
stippled vaginal epithelial cells
clue cells - gardnerella vaginalis
100
streptococcus bovis (gallolyticus) bacterium
colon cancer
101
tennis racket shaped cytoplasmic organelles (EM) in langerhans cells
birbeck granules (Langerhans cell histiocytosis)
102
thousands of polyps on colonoscopy
FAP (AD in apc)
103
thrombi make white/red layers
lines of zahn - arterial thrombus, layers of platelets, RBCs
104
thumb sign on lateral neck x-ray
epiglottitis (H flu)
105
thyroid like appearance of kidney
chronic pyelonephritis (usually due to recurrent infections)
106
tram track appearnce of capillary loops of glomerular BM on light microscopy
membranoproliferative glomerulonephritis
107
triglyceride accumulation in liver cell vacuoles
fatty liver diseae (alcoholic or metabolic syndrome)
108
waxy casts with very low urine flow
chronic end stage renal disease
109
WBC casts in urine
acute pyleonephritis
110
WBCs that look "smudged"
CLL (almost always b cells)
111
Wire loop glomerular capillary appearance on light microscopy
Diffuse proliferative glomerulonephritis - usually seen with lupus
112
yellowish csf
xanthochromia (e.g. due to SAH)
