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Rapid Review > Classic Labs/Findings > Flashcards

Classic Labs/Findings Flashcards

1
Q

Colonies of mucoid Psudomonas in lungs

A

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

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2
Q

V AFP in amniotic fluid/maternal serum

A

Down syndrome, Edwards syndrome

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3
Q

^ ß-hCG, v PAPP-A on first trimester screening

A

Down Syndrome

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4
Q

^ serum homocysteine, ^ mehtylmalonic acid, v folate

A

Vitamin B12 deficiency

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5
Q

Anti-histone antibodies

A

Drug-induced SLE (eg hydralazine, isoniazid, phenytoin, TNF alpha inhibitors)

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6
Q

V T cells, V PTH, V CA +2, absent thymic shadow on CXR

A

Thymic aplasia (Di George syndrome, velocardiofacial syndrome)

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7
Q

Large granules in phagocytes, immunodeficiency

A

Chédiak-Higashi disease (congenital failure of phagolysosome formation)

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8
Q

Recurrent infections, eczema, thrombocytopenia

A

Wiskott-Aldrich syndrome

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9
Q

Optochin sensitivity

A

Sensitive: S pneumoniae; resistant viridans streptococci (S mutans, S sanguis)

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10
Q

Novobiocin response

A

Sensitive S epidermidis; resistant S saprophyticus

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11
Q

Bacitracin response

A

Sensitive: S pyogenes (group A); resistant: S agalactiae (group B)

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12
Q

Branching gram + rods with sulfur granules

A

Actinomyces israelii

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13
Q

Hilar lymphadenopathy, peripheral granulomatous lesion in middleof lower lung lobes ( can calcify)

A

Ghon complex (1º TB: Mycobacterium bacilli)

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14
Q

“Thumb sign” on lateral neck x-ray

A

Epiglottitis (Haemophilus influenzae)

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15
Q

Bacteria covered vaginal epithelial cells

A

Clue cells (Gardnerella Vaginalis)

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16
Q

Dilated cardiomyopathy with apical atrophy

A

Chagas disease (Trypanosoma cruzi)

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17
Q

Atypical lymphocytes, heterophile antibodies

A

Infectious mononucleosis (EBV infection)

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18
Q

Eosinophilic intranuclear inclusions with perinuclear halo

A

Cells infected by herpesviruses (eg HSV, VZV, CMV)

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19
Q

“Steeple” sign on frontal CXR

A

Croup (parainfluenza virus)

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20
Q

Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar neurons

A

Negri bodies of rabies

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21
Q

Ring-enhancing brain lesion on CT/MRI in AIDS

A

Toxoplasma gondii, CNS lymphoma

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22
Q

Psammoma bodies

A

Meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of the endometrium and ovary

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23
Q

“Delta wave” on ECG, short PR interval, supraventricular tachycardia

A

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

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24
Q

“Boot shaped” heart on x-ray

A

Tetralogy of Fallot (due to RVH)

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25
Q

Rib notching (inferior surface on X-ray)

A

Coarctation of the aorta

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26
Q

Granuloma with giant cells after pharyngeal infection

A

Aschoff bodies (rheumatic fever)

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27
Q

Electrical alternans (alternating amplitude on ECG)

A

Cardiac tamponade

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28
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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29
Q

“Brown” tumor of bone

A

Hyperparathyroidism or osteitis fibrosa cystica (deposited hemosiderm from hemorrhage gives brown color)

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30
Q

Hypertension, hypokalemia, metabolic alkalosis

A

1º hyperaldosteronism (eg Conn syndrome)

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31
Q

Mucin-filled cell with peripheral nucleus

A

“Signet ring” (gastric carcinoma)

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32
Q

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

A

Celiac disease (diarhea, weight loss)

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33
Q

Narrowing of bowel lumen on barium x-ray

A

“String sign” (Crohn disease)

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34
Q

“Lead pipe” appearance of colon on abdominal imaging

A

Ulcerative colitis (loss of haustra)

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35
Q

Thousands of polyps on colonoscopy

A

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

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36
Q

“Apple core” lesion on barium enema x-ray

A

Colorectal cancer (usually left sided)

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37
Q

Eosinophilic cytoplasmic inclusion in liver cell

A

Mallory body (alcoholic liver disease)

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38
Q

Triglyceride accumulation in liver cell vacuoles

A

Fatty liver disease (alcoholic or metabolic syndrome)

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39
Q

Anti-smooth muscle antibodies (ASMAs), anti-liver/kidney microsomal-1 (anti LKM1) antibodies

A

Autoimmune hepatitis

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40
Q

“Nutmeg” appearance of liver

A

Chronic passive congestion of liver due to right heart failure or Budd-Chiari Syndrome

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41
Q

Antimitochondrial antibodies (AMAs)

A

1º biliary cholangitis (female, cholestasis, portal hypertension)

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42
Q

Low serum ceruloplasmin

A

Wilson disease (hepatolenticular degeneration; Kayser-Fleischer rings due to copper accumulation)

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43
Q

Migratory thrombophlebitis (leading to migrating DVTs and vasculitis)

A

Trousseau syndrome (adenocarcinoma of pancreas or lung)

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44
Q

Hypersegmented neutrophils

A

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

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45
Q

Basophilic nuclear remnants in RBCs

A

Howell-Jolly bodies (due to splenectomy or nonfunctional spleen)

46
Q

Basophilic stippling of RBCs

A

Lead poisoning or sideroblastic anemia

47
Q

Hypochromic, microcytic anemia

A

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

48
Q

“Hair on end” (“crew cut”) appearance on x-ray

A

ß-thalassemia, sickle cell disease (marrow expansion)

49
Q

Anti-GpIIb/IIIa antibodies

A

Immune thrombocytopenia

50
Q

High level of D-Dimers

A

DVT, DIC

51
Q

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

A

Reed-Sternberg cells (Hodgkin lymphoma)

52
Q

Sheets of medium -sized lymphoid cells with scattered pale, tingible body- laden macrophages (“starry sky” histology)

A

Burkitt lymphoma (t[8:14] c myc activation, associated with EVB; “starry sky” made up of malignant cells)

53
Q

Lytic (“punched out” ) bone lesions on x-ray

A

Multiple myeloma

54
Q

Monoclonal spike on serum protein electrophoresis

A

Multiple myeloma (usually IgG or IgA)
Waldenström macroglobulinemia (IgM)
Monoclonal gammopathy of undetermined significance

55
Q

Stack of RBCs

A

Rouleaux formation (high ESR, multiple myeloma)

56
Q

Azurophilic peroxidase + granular inclusions in granulocytes and myeloblasts

A

Auer rods (APL)

57
Q

WBCs that look “smudged”

A

CLL

58
Q

“Tennis racket” -shaped cytoplasmic organelles (EM) in Langerhans cells

A

Birbeck granules (Langerhans cell histocytosis)

59
Q

“Soap bubble” in femur or tibia on x-ray

A

Giant cell tumor of bone (generally benign)

60
Q

Raised periosteum (creating a “Codman triangle”)

A

Aggressive bone lesion (eg osteosarcoma, Ewing sarcoma)

61
Q

“Onion skin” periostal reaction

A

Ewing sarcoma(malignant small blue cell tumor)

62
Q

Anti-IgG antibodies

A

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

63
Q

Rhomboid crystals, + birefringent

A

Pseudogout (calcium pyrophosphate dihydrate crystals)

64
Q

Needle shaped, - birefringent crystals

A

Gout (monosodium urate crystals)

65
Q

^ uric acid levels

A

Gout, Lesch-Nyhan Syndrome, tumor lysis syndrome, loops and thiazide diuretics

66
Q

“Bamboo spine” on x-ray

A

Ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27)

67
Q

Antinuclear antibodies (ANAs: anti-smith and anti dsDNA)

A

SLE (type III hypersensitivity)

68
Q

Antineutrophil cytoplasmic antibodies (ANCAs)

A

Microscopic polyangiitis and eosinophilic granulomatosis with polyangiitis (MPO-ANCA/p-ANCA); granulomatosis with polyangiitis (PR3-ANCA/c-ANCA); primary sclerosing cholangitis (MPO-ANCA/p-ANCA)

69
Q

Anticentromere antibodies

A

Scleroderma (CREST syndrome)

70
Q

Anti-topoisomerase antibodies

A

Diffuse scleroderma

71
Q

Anti-desmoglein (anti-desmosome) antibodies

A

Pemphigus vulgaris (blistering)

72
Q

Keratin pearls on a skin biopsy

A

Squamous cell carcinoma

73
Q

^ AFP in amniotic fluid/maternal serum

A

Dating error, anencephaly, spina bifida (open neural tube defects)

74
Q

Bloody or yellow tap on lumbar puncture

A

Xanthochromia (due to subarachnoid hemorrhage)

75
Q

Eosinophilic cytoplasmic inclusion in neuron

A

Lewy body (parkinson disease and Lewy body dementia)

76
Q

Extracellular amyloid deposition in gray matter of brain

A

Senile plaques (Alzheimer disease)

77
Q

Depigmentation of neurons in substantia nigra

A

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

78
Q

Protein aggregates in neurons from hyperphosphorylation of tau protein

A

Neurofibrillary tangles (Alzheimer disease) and Pick bodies (pick disease)

79
Q

Silver-staining spherical aggregation of tau proteins in neurons

A

Pick bodies (frontotemporal dementia: progressive dementia, changes in personality)

80
Q

Pseudopalisading pleomorphic tumor cells on brain biopsy

A

Glioblastoma multiforme

81
Q

Circular grouping of dark tumor cells surrounding pale neurofibrils

A

Home-Wright rossettes (neuroblastoma, medulloblastoma)

82
Q

“Waxy” casts with very low urine flow

A

Chronic end-stage renal disease

83
Q

WBC casts in urine

A

Acute pyelonephritis, transplant rejection, tubulointerstitial inflammation

84
Q

RBC casts in urine

A

Glomerulonephritis

85
Q

Tram-track appearance of capillary loops of glomerular basement membranes on light microscopy

A

Membranoproliferative glomerulonephritis

86
Q

Anti glomerular basement membrane antibodies

A

Goodpasture syndrome (glomerulonephritis and hemoptysis)

87
Q

Cellular crescents in Bowman capsule

A

Rapidly progressive (crescentic) glomerulonephritis

88
Q

Wire loop glomerular capillary appearance on light microscopy

A

Diffuse proliferative glomerulonephritis (usually seen with lupus)

89
Q

Linear appearance of Ig G deposition on glomerular

A

Goodpasture syndrome

90
Q

“Lumpy bumpy” appearance of glomeruli on immunofluorescence

A

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

91
Q

Necrotizing vasculitis (Lungs) and necrotizing glomerulonephritis

A

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

92
Q

Nodular hyaline deposits in glomeruli

A

Kimmelstiel-Wilson nodules (diabethic nephropathy)

93
Q

Podocyte fusion or “effacement” on electron microscopy

A

Minimal change disease (child with nephrotic syndrome)

94
Q

“Spikes” on basement membrane, “dome-like” subepithelial deposits

A

Membranous nephropathy (nephrotic syndrome)

95
Q

Thyroid-like appearance of kidney

A

Chronic pyelonephritis (usually due to recurrent infections)

96
Q

Granular casts in urine

A

Acute tubular necrosis (eg ischemia or toxic injury)

97
Q

hCG elevated

A

Multiple gestations, hydatidiform moles, choriocarcinoms, Down Syndrome

98
Q

Dysplastic squamous cervical cells with “raisinoid” nuclei and hyperchromasia

A

Koilocytes (HPV: predisposes to cervical cancer)

99
Q

Sheets of uniform “fried eggs” cells, ^ hCG, ^ LDH

A

Dysgerminoma

100
Q

Disarrayed granulosa cells arranged around collections of eosinophilic fluid

A

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

101
Q

“Chocolate cyst” of ovary

A

Endometriosis (frequently involves both ovaries)

102
Q

Mammary gland (‘blue dommed”) cyst

A

Fibrocystic change of the breast

103
Q

Glomerulus-like structure surrounding vessel in germ cells

A

Schiller-Duval bodies (yolk sac tumor)

104
Q

Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells

A

Reinke crystals (Leydig cell tumor)

105
Q

Thrombi made of white/red layers

A

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

106
Q

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

A

Bronchial asthma (Charcot-Leyden crystals:eosinophilic granules)

107
Q

Desquamated epithelium casts in sputum

A

Curschmann spirals (bronchial asthma; can result in whorled mucous plugs)

108
Q

“Honeycomb lung” on x-ray or CT

A

Idiopathic pulmonary fibrosis

109
Q

Iron containing nodules in alveolar septum

A

Ferruginous bodies (asbestosis: ^ chance of lung cancer)

110
Q

Bronchogenic apical lung tumor on imaging

A

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

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