classic labs/findings 2

Question 1

Dysplastic squamous cervical cells with “raisinoid” nuclei and hyperchromasia

Answer 1

Koilocytes (HPV: predisposes to cervical cancer)

Question 2

Electrical alternans (alternating amplitude on EKG)

Answer 2

Pericardial tamponade

Question 3

Enlarged cells with intranuclear inclusion bodies

Answer 3

“Owl eye” appearance of CMV

Question 4

Enlarged thyroid cells with ground-glass nuclei with central clearing

Answer 4

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

Question 5

Eosinophilic cytoplasmic inclusion in liver cell

Answer 5

Mallory body (alcoholic liver disease)

Question 6

Eosinophilic cytoplasmic inclusion in neuron

Answer 6

Lewy body (Parkinson disease and Lewy body dementia)

Question 7

Eosinophilic globule in liver

Answer 7

Councilman body (viral hepatitis, yellow fever), represents hepatocyte undergoing apoptosis

Question 8

Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar neurons

Answer 8

Negri bodies of rabies

Question 9

Extracellular amyloid deposition in gray matter of brain

Answer 9

Senile plaques (Alzheimer disease)

Question 10

Giant B cells with bilobed nuclei with prominent inclusions

Answer 10

Reed-Sternberg cells (Hodgkin lymphoma) (“owl’s eye”)

Question 11

Glomerulus-like structure surrounding vessel in germ cells

Answer 11

Schiller-Duval bodies (yolk sac tumor)

Question 12

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

Answer 12

β-thalassemia, sickle cell disease (marrow expansion)

Question 13

hCG elevated

Answer 13

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

Question 14

Heart nodules (granulomatous)

Answer 14

Aschoff bodies (rheumatic fever)

Question 15

Heterophile antibodies

Answer 15

Infectious mononucleosis (EBV)

Question 16

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

Answer 16

Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)

Question 17

High level of d-dimers

Answer 17

DVT, PE, DIC

Question 18

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

Answer 18

Ghon complex (1° TB: Mycobacterium bacilli)

Question 19

“Honeycomb lung” on x-ray or CT

Answer 19

Interstitial pulmonary fibrosis

Question 20

Hypercoagulability (leading to migrating DVTs and vasculitis)

Answer 20

Trousseau syndrome (adenocarcinoma of pancreas or lung)

Question 21

Hypersegmented neutrophils

Answer 21

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

Question 22

Hypertension, hypokalemia, metabolic alkalosis

Answer 22

1° hyperaldosteronism (Conn syndrome)

Question 23

Hypochromic, microcytic anemia

Answer 23

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

Question 24

Intranuclear eosinophilic droplet-like bodies

Answer 24

Cowdry type A bodies (HSV or VZV)

Question 25

Iron-containing nodules in alveolar septum

Answer 25

Ferruginous bodies (asbestosis: ^chance of mesothelioma)

Question 26

Keratin pearls on a skin biopsy

Answer 26

Squamous cell carcinoma

Question 27

Large granules in phagocytes, immunodeficiency

Answer 27

Chédiak-Higashi disease (congenital failure of phagolysosome formation)

Question 28

“Lead pipe” appearance of colon on abdominal imaging

Answer 28

Ulcerative colitis (loss of haustra)

Question 29

Linear appearance of IgG deposition on glomerular and alveolar basement membranes 

Answer 29

Goodpasture syndrome

Question 30

Low serum ceruloplasmin

Answer 30

Wilson disease (hepatolenticular degeneration)

Question 31

“Lumpy bumpy” appearance of glomeruli on immunofluorescence

Answer 31

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

Question 32

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

Answer 32

Multiple myeloma

Question 33

Mammary gland (“blue domed”) cyst

Answer 33

Fibrocystic change of the breast

Question 34

Monoclonal antibody spike ƒ

Answer 34

-Multiple myeloma (usually IgG or IgA) ƒ-Monoclonal gammopathy of undetermined significance (MGUS consequence of aging) ƒ-Waldenström (M protein = IgM) macroglobulinemia ƒ -Primary amyloidosis

Question 35

Mucin-filled cell with peripheral nucleus

Answer 35

“Signet ring” (gastric carcinoma)