Classic Labs/Findings Flashcards
1
Q
Anticentromere antibodies
A
Scleroderma (CREST)
2
Q
Antidesmoglein (epithelial) antibodies
A
Pemphigus vulgaris (blistering)
3
Q
Antiglomerular basement membrane antibodies
A
Goodpasture’s syndrome (glomerulonephritis and hemoptysis)
4
Q
Antihistone antibodies
A
Drug induced SLE (hydralazine, isoniazid, phentynoin, procainamide)
5
Q
Anti-IgG antibodies
A
Rheumatoid arthritis– systemic inflammation, joint pannus, boutonniere deformity
6
Q
Antimitochondrial antibodies
A
Primary biliary cirrhosis– female, cholestasis, portal hypertension
7
Q
Antineutrophil cytoplasmic antibodies (ANCA’s)
A
c-ANCA- Wegener’s granulomatosis with polyangiitis; p-ANCA- microscopic polyangiitis, Churg-Strauss syndrome
8
Q
ANA: anti-Smith and 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-transglutaminase/anti-gliadin/anti-endomysial antibodies
A
Celiac disease - diarrhea, distention, weight loss
12
Q
Apple core lesion on abdominal x ray
A
Colorectal cancer (usually left-sided)
13
Q
Azurophilic peroxidase-positive granular inclusions in granulocytes and myeloblasts
A
Auer rods- acute myelogenous leukemia, especially the promyelocytic (M3) type
14
Q
Bacitracin response
A
Sensitive: group A strep aka Strep pyogenes; Resistant: group B strep aka Strep agalactiae
15
Q
Bamboo spine on x-ray
A
Ankylosing spondylitis (chronic inflammatory arthritis– HLA B27)
16
Q
Basophilic nuclear remnants in RBC’s
A
Howell-Jolly bodies- due to splenectomy or non-functional spleen
17
Q
Basophilic stippling of RBC’s
A
Lead poisoning or sideroblastic anemia
18
Q
Bloody tap on LP
A
Subarachnoid hemorrhage
19
Q
Boot shaped heart on x-ray
A
Tetralogy of Fallot; RVH
20
Q
Branching gram positive rods with sulfur granules
A
Actinomyces israelii
21
Q
Bronchogenic apical lung tumor on imaging
A
Pancoast tumor- can compress sympathetic ganglion and cause Horner’s syndrome
22
Q
Brown tumor of bone
A
Hyperparathyroidism of osteitis fibrosa cystica; deposited hemosiderin from hemorrhage gives brown color
23
Q
Cardiomegaly and apical atrophy
A
Chagas’ disease (Trypanosoma cruzi)
24
Q
Cellular crescents in Bowman’s capsule
A
Rapidly progressive crescenteric glomerulonephritis
25
Chocolate cyst of ovary
Endometriosis (frequently bilateral)
26
Circular grouping of dark tumor cells surrounding pale neurofibrils
Homer-Wright rosettes- neuroblastoma medulloblastoma, retinoblastoma
27
Colonies of mucoid Pseudomonas in lungs
Cystic fibrosis- AR mutation in CFTR resulting in fat-soluble vitamin deficiency and mucus plugs
28
Decreased alpha-fetoprotein in amniotic fluid/maternal serum
Down syndrome or other chromosomal abnormality
29
Degeneration of dorsal column nerves
Tabes dorsalis (tertiary syphilis), subacute combined degeneration (dorsal columns and lateral corticospinal tracts affected)
30
Depigmentation of neurons in substantia nigra
Parkinson's disease-- basal ganglia disorder characterized by rigidity, resting tremor, bradykinesia
31
Desquamated epithelium casts in sputum
Curschmann's spirals- bronchial asthma; can result in whorled mucus plugs
32
Disarrayed granulosa cells in eosinophilic fluid
Call-Exner bodies- granulosa-theca cell tumor of the ovary
33
Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia
Koilocytes-- HPV; predisposes to cervical cancer
34
Enlarged cells with intranuclear inclusion bodies
Owl;s eye appearance of CMV
35
Enlarged thyroid cells with ground glass nuclei
Orphan Annie's eyes nuclei- papillary carcinoma of the thyroid
36
Eosinophilic cytoplasmic inclusions in liver cell
Mallory bodies (alcoholic liver disease)
37
Eosinophilic cytoplasmic inclusion in nerve cell
Lewy body (Parkinson's disease)
38
Eosinophilic globule in the liver
Councilman body (toxic or viral hepatitis, often yellow fever)
39
Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells
Negri bodies of rabies (Lyssavirus)
40
Extracellular amyloid deposition in gray matter of brain
Senile plaques of Alzheimers disease
41
Giant B cells with bilobed nuclei with prominent inclusions (owl's eye)
Reed-Sternberg cells of Hodgkin's lymphoma
42
Glomerulus like structure surrounding vessel in germ cells
Schiller-Duval bodies (yolk sac tumor)
43
Hair on end (crew cut) appearance on x-ray
beta-thalassemia, sickle cell anemia (marrow expansion)
44
hCG elevated
Choriocarcinoma, hydatidiform mole (occurs with and without embryo)
45
Heart nodules (granulomatous)
Aschoff bodies (rheumatic fever)
46
Heterophile antibodies
Infectious mono (EBV)
47
Hexagonal, double-pointed, needle-like crystals in bronchial secretions
Bronchial asthma-- Charcot-Leyden crystals; eosinophilic granules
48
High level of D-dimers
DVT, pulmonary embolism, DIC
49
Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Ghon complex (primary TB; mycobacterium bacilli)
50
Honeycomb lung on x-ray or CT
Interstitial pulmonary fibrosis
51
Hypercoagulability leading to migrating DVT's and vasculitis
Trousseau's syndrome (adenocarcinoma of pancreas or lung)
52
Hypersegmented neutrophils
Megaloblastic anemia- B12 deficiency characterized by neurologic symptoms; folate deficiency does not have neuro symptoms
53
Hypertension, hypokalemia, metabolic alkalosis
Conn's syndrome
54
Hypochromic, microcytic anemia
Iron deficiency anemia, lead poisoning, thalassemia (fetal hemoglobin sometimes present)
55
Increased alpha-fetoprotein in amniotic fluid/maternal serum
Dating error, anencephaly, neural tube defects
56
Increased uric acid levels
Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics
57
Intranuclear eosinophilic droplet-like bodies
Cowdry A bodies (HSV or CMV)
58
Iron containing nodules in alveolar sputum
Ferruginous bodies: asbestosis leads to increased chance of mesothelioma
59
Keratin pearls on skin biopsy
Squamous cell carcinoma
60
Large lysosomal vesicles in phagocytes, immunodeficiency
Chediak-Higashi disease (congenital failure of phagolysosome formation)
61
Lead pipe appearance of colon on barium enema x-ray
Ulcerative colitis (loss of haustra)
62
Linear appearance of IgG deposition on glomerular basement membrane
Goodpasture's syndrome
63
Low serum ceruloplasmin
Wilson's disease
64
Lumpy bumpy appearance of glomeruli on immunofluorescence
Postreptococcal glomerulonephritis (immune complex deposition of IgG and C3b)
65
Lytic (hole punched) bone lesions on x-ray
Multiple myeloma
66
Mammary gland (blue domed) cyst
Fibrocystic change of the breast
67
Monoclonal antibody spike
Multiple myeloma (usually IgG or IgA); MGUS (normal consequence of aging); Waldenstrom's macroglobulinemia (M protein= IgM); Primary amyloidosis
68
Mucin filled with peripheral nucleus
Signet ring (gastric carcinoma)
69
Narrowing of bowel lumen on barium x-ray
String sign (Crohn's disease)
70
Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis
Granulomatosis with polyangiitis (Wegener's c-ANCA positive) & Goodpasture's syndrome (anti-basement membrane antibodies)
71
Needle shaped negatively birefringent crystals
Gout (MSU crystals)
72
Nodular hyaline deposits in glomeruli
Kimmelstiel-Wilson disease (diabetic nephropathy)
73
Novobiocin response
Sensitive: Staph epidermidis; Resistant: Staph saprophyticus
74
Nutmeg appearance of the liver
Chronic passive congestion of liver due to right heart failure
75
Onion skin periosteal reaction
Ewing's sarcoma (malignant round cell tumor)
76
Optochin response
Sensitive: Strep pneumo; Resistant: Viridans strep
77
Periosteum raised from bone, creating triangular area
Codman's triangle on x-ray-- osteosarcoma, Ewing's sarcoma, pyogenic osteomyelitis
78
Podocyte fusion or "effacement" on electron microscopy
Minimal change disease (child with nephrotic syndrome)
79
Polished, "ivory-like" appearance of bone at cartilage erosion
Eburnation- osteoarthritis resulting in bony sclerosis
80
Protein aggregates in neurons from hyperphosphorylation of protein tau
Neurofibrillary tangles (Alzheimer's) and Pick's bodies (Pick's disease)
81
Psammoma bodies
Meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of the endometrium and ovary
82
Pseudopalisading tumor cells on brain biopsy
Glioblastoma multiforme
83
RBC casts in urine
Acute glomerulonephritis
84
Rectangular, crystal-like, cytoplasmic inclusions of Leydig cells
Reinke crystals (Leydig cell tumors)
85
Renal epithelial casts in urine
Acute toxic/viral nephrosis
86
Rhomboid crystals, positively birefringent
Pseudogout (calcium pyrophosphate dihydrate crystals)
87
Rib notching
Coarctation of the aorta
88
Ring enhancing lesions in AIDS
Toxoplasma gondii, CNS lymphoma
89
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)
90
Silver staining spherical aggregation of tau proteins in neurons
Pick bodies-- Pick's disease characterized by progressive dementia, changes in personality
91
Soap bubble in femur or tibia on x-ray
Giant cell tumor of bone (generally benign)
92
Spikes on basement membrane, "dome-like" subepithelial deposits
Membranous glomerulonephritis (may progress to nephrotic syndrome)
93
Stacks of RBC's
Rouleaux formation- high ESR, multiple myeloma
94
Stippled vaginal epithelial cells
Clue cells of Gardnerella vaginalis
95
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells
Birbeck granules- Langerhans cell histiocytosis or histiocytosis X; eosinophilic granuloma
96
Thrombi made of white/red layers
Lines of Zahn-- arterial thrombus, layers of platelets/RBC's
97
Thumb sign on lateral x-ray
Epiglottitis (Haemophilus influenzae)
98
Thryoid like appearance of kidney
Chronic bacterial pyelonephritis
99
Tram track appearance of capillary loops of glomerular basement membranes on light microscopy
Membranoproliferative glomerulonephritis
100
Triglyceride accumulation in liver cell vacuoles
Fatty liver disease (alcoholic or metabolic syndrome)
101
Waxy casts with very low urine flow
Chronic end-stage renal disease
102
WBC casts in urine
Acute pyelonephritis
103
WBC's that look "smudged"
CLL (almost always B cell)
104
Wire loop glomerular capillary appearance on light microscopy
Lupus nephropathy
105
Yellowish CSF
Xanthochromia (e.g. due to subarachnoid hemorrhage)
106
Acanthocyte (spur cell)
Liver disease, abetalipoproteinemia (states of cholesterol dysregulation)
"Acantho" = spiny
107
Spherocytes
Hereditary spherocytosis, Autoimmune Hemolysis
108
Teardrop cell
Bone Marrow infiltration (e.g. myelofibrosis)
109
Target cell
HbC disease, Asplenia, Liver disease, Thalassemia
