Classic Labs/Findings Flashcards
anticentromere antibodies
Scleroderma
CREST
antidesmoglein (epithelial) antibodies
Pemphigus vulgaris
blistering
anti-glomerular basement membrane antibodies
Goodpasture syndrome
glomerulonephritis & hemoptysis
antihistone antibodies
Drug-induced SLE
hydralazine, INH, phenytoin, procainamide
anti-IgG antibodies
Rheumatoid arthritis (systemic inflamm, joint pannus, boutonneière deformity)
antimitochondrial antibodies (AMA)
Primary biliary cirrhosis
female, cholestasis, portal HTN
antineutrophil cytoplasmic antibodies (ANCA)
Microscopic polyangiitis & Churg-Strauss syndrome (MPO-ANCA/p-ANCA);
Granulomatosis w/ polyangiitis (Wegener; PR3-ANCA/c-ANCA)
antinuclear antibodies (ANA: anti-Smith/snRNPs & anti-dsDNA)
SLE
type III HSR
antiplatelet antibodies
Idiopathic thrombocytopenia purpura
ITP
anti-topoisomerase antibodies
Diffuse systemic scleroderma
anti-transglutaminase/anti-gliadin/anti-endomysial antibodies
Celiac disease
diarrhea, distension, wt loss
‘apple core’ lesion on abdominal x-ray
Colorectal cancer
usually left-sided
azurophilic peroxidase + granular inclusions in granulocytes & myeloblasts
Auer rods (AML, esp PML M3 type)
bacitracin response
Resistance: S. agalactiae (group B)
Sensitive: S. pyogenes (group A)
B-BRAS
‘bamboo spine’ on x-ray
Ankylosing spondylitis
chronic inflammatory arthritis: HLA-B27
basophilic nuclear remnants in RBCs
Howell-Jolly bodies
d/t splenectomy or nonfunctional spleen
basophilic stippling of RBCs
Lead poisoning,
Sideroblastic anemia
bloody tap on LP
subarachnoid hemorrhage
‘boot-shaped’ heart on x-ray
Tetralogy of Fallot,
RVH
branching gram-positive rods with sulfur granules
Actinomyces israelii
bronchogenic apical lung tumor on imaging
Pancoast tumor
can compress sympathetic ganglion –> Horner syndrome
‘brown’ tumor of bone
Hyperparathyroidism OR Osteitis fibrosa cystica
deposited hemosiderin from hemorrhage –> brown color
cardiomegaly w/ apical atrophy
Chagas disease
Trypansoma cruzi
cellular crescents in Bowman capsule
Rapidly progressive crescentic glomerulonephritis
RPGN
‘chocolate cyst’ of ovary
Endometriosis
frequently involves both ovaries
circular grouping of dark tumor cells surrounding pale neurofibrils
Homer-Wright rosettes
neuroblastoma, retinoblastoma, medulloblastoma
colonies of mucoid Pseudomonas in lungs
Cystic fibrosis (AR mutation in CFTR gene --> fat-soluble vit def & mucous plugs)
decreased AFP in amniotic fluid/maternal serum
Down syndrome & other chromosomal abnormalities
degeneration of dorsal column nerves
Tabes dorsalis (3' syphilis), Subacute combined degeneration (B12 def --> dorsal columns & lateral corticospinal tracts affected)
depigmentation of neurons in substantia nigra
Parkinson disease
basal ganglia d/o: rigidity, 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 brain gray matter
Senile plaques
Alzheimer disease
giant B cells with bilobed nuclei with prominent inclusions
Reed-Sternberg cells CD15/CD30+
Hodgkin lymphoma
glomerulus-like structure surrounding vessel in germ cells
Schiller-Duval bodies
Yolk sac tumor
‘hair on end’ crew-cut appearance on x-ray
Beta-thalassemia OR Sickle cell anemia
marrow expansion
hCG elevated
choriocarcinoma, hydatidiform mole (occurs w/ and w/o embryo, and multiple pregnancies)
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,
PE,
DIC
hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Ghon complex
1’ TB: Mycobacterium bacilli
‘honeycomb lung’ on x-ray or CT
Interstitial pulmonary fibrosis
hypercoagulability (leading to migrating DVTs and vasculitis)
Trousseau syndrome
adenocarcinoma of pancreas or lung
hypersegmented neutrophils
Megaloblastic anemia (B12 def: neuro sx's; folate def: no neuro sx's)
hypertension, hypokalemia, metabolic alkalosis
Conn syndrome
hypochromic, microcytic anemia
Iron deficiency anemia,
Lead poisoning,
Thalassemia (fetal Hb sometimes present)
increased AFP in amniotic fluid/maternal serum
Dating error,
Anencephaly,
Spina bifida (NTDs)
increased uric acid levels
Gout,
Lesch-Nyhan syndrome,
Tumor lysis syndrome,
Loop & Thiazide diuretics
intranuclear eosinophilic droplet-like bodies
Cowdry type A bodies
HSV or CMV
iron-containing nodules in alveolar septum
Ferruginous bodies (abestosis: increase chance of mesothelioma)
keratin pearls on skin biopsy
Squamous cell carcinoma
large lysosomal vesicles in phagocytes, immunodeficiency
Chédiak-Higashi disease
congenital failure if 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 syndrome
low serum ceruloplasmin
Wilson disease
hepatolenticular degeneration
‘lumpy bumpy’ appearance of glomeruli on IF
Poststreptococcal glomerulonephritis
immune complex deposition of IgG & C3b
lytic (‘hole punched’) bone lesions on x-ray
Multiple myeloma
mammary gland (‘blue domed’) cyst
Fibrocystic change of the breast
monoclonal antibody spike
Multiple myeloma (usually IgG or IgA), Monoclonal gammopathy of undetermined significance (MGUS consequence of aging), Waldenström (M protein = IgM) macroglobulinemia, Primary amyloidosis
mucin-filled cell with peripheral nucleus
‘Signet ring’
gastric carcinoma
narrowing of bowel lumen on barium x-ray
‘String sign’
Crohn disease
necrotizing vasculitis (lungs) and necrotizing glomerulonephritis
Granulomatosis w/ polyangiitis (Wegener; PR3-ANCA/c-ANCA), Goodpasture syndrome (anti-basement membrane antibodies)
needle-shaped, negatively birefringent crystals
Gout
monosodium urate crystals
nodule hyaline deposits in glomeruli
Kimmelstiel-Wilson nodules
diabetic nephropathy
Novobiocin response
Resistant: S. saprophyticus
Sensitive: S. epidermidis
‘nutmeg’ appearance of liver
Chronic passive congestion of liver d/t RHF
‘onion skin’ periosteal reaction
Ewing sarcoma
malignant round-cell tumor
optochin response
Resistant: viridans strep (S. mutans)
Sensitive: S. pneumoniae
periosteum raised from bone; creating triangular area
Codman triangle on x-ray
Osteosarcoma, Ewing sarcoma, pyogenic osteomyelitis
podocyte fusion of ‘effacement’ on EM
Minimal change disease
child w/ nephropathy
polished, ‘ivory-like’ appearance of bone at cartilage erosion
Eburnation
osteoarthritis resulting in bony sclerosis
protein aggregates in neurons from hyperphosphorylation of tau protein
Neurofibrillary tangle (Alzheimer disease), Pick bodies (Pick disease/FTLD)
psammoma bodies
Papillary thyroid carcinoma, Papillary serous carcinoma of the endometrium/ovary, Meningioma, Mesothelioma
pseudopalisading tumor cells on brain biopsy
Gliobastoma 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 renal injury
rhomboid crystals, positively birefringent
Pseudogout
calcium pyrophosphate dihydrate crystals
rib notching
Coarctation of the aorta
ring-enhancing brain lesion in AIDS
Toxoplasma gondii,
CNS lymphoma
sheets of medium-sized lymphoid cells with scatted pale, tingible body-laden macrophages
(‘starry sky’ histology)
Burkitt lymphoma
t[8:14] c-myc activation, a/w EBV; ‘black sky’ made up of malignant cells
silver-staining spherical aggregation of tau proteins in neurons
Pick bodies (Pick 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)
- different from MPGN!
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/histiocytosis X: eosinophilic granuloma
thrombi made of white/red layers
Lines of Zahn
arterial thrombus, layers of platelets/RBCs
‘thumb sign’ on lateral x-ray
Epiglottitis
H. influenzae
thyroid-like appearance of kidneys
chronic bacterial pyelonephritis
‘tram-track’ appearance of capillary loops of glomerular basement membranes on LM
Membranoproliferative glomerulonephritis
MPGN
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 cells
‘wire loop’ glomerular capillary apperance of LM
Lupus nephropathy (DPGN = nephritic)
Yellowish CSF
Xanthochromia
e.g. d/t subarachnoid hemorrhage