Classic Labs/Findings Flashcards
lab - Antidesmoglein (epithelial) antibodies
Phemphigus vulgaris - blistering
lab - Anticentromere antibodies
Scleroderma / CREST
lab - anti-glomerular basement membrane antibodies
Goodpasture’s syndrome
Glomerulonephritis and haemoptysis
lab - Antihistone antibodies
Drug induced SLE (hydralazine, isoniazid, phenytoin, procainamide)
lab - Anti IgG antibodies
Rheumatoid arthritis
systemic inflammation, joint pannus, boutonniere deformity
lab - Antimitochondrial antibodies (AMA’s)
Primary biliary cirrhosis (female, cholestasis, portal hypertension)
lab - Antineutrophil cytoplasmic antibodies (ANCAs)
Vasculitis
- cANCA - granulomatosis with polyangiitis - Wegener’s
- pANCA - microscopic polyangiitis - Churg-Strauss syndrome
lab - Antinuclear antibodies
ANAs: anti-smith and anti-dsDNA
SLE (type III hypersensitivity)
lab - Antiplatelet antibodies
Idiopathic thrombocytopenic purpura
lab - Anti-topoisomerase antibodies
diffuse systemic scleroderma
lab - Antitransglutaminase/anti-gliadin/anti-endomysial antibodies
Celiac disease (diarrhoea, distension, weightloss)
lab - “Apple-core” lesion on abdominal Xray
Colorectal cancer
usually left sided
lab - Azurophilic peroxidase-positive granular inclusions in granulocytes and myeloblasts
Auer rods
AML, especially the promyelocytic M3 type
lab - Bacitracin response
Sensitive - Streptococcus pyogenes (Group A)
Resisstant: Streptococcus agalactiae (group B)
lab - “Bamboo spine” on Xray
Ankylosing spondylitis
- chronic inflammatory arthritis: HLA B27
lab - Basophilic nuclear remnants in RBCs
Howell-Jolly bodies (due to splenectomy or non-functional spleen)
lab - Basophilic stippling of RVCs
Lead poisoning or sideroblastic anaemia
lab - Bloody tap on LP
Subarachnoid haemorrhage
lab - “bootshaped” heart on Xray
Tetralogy of Fallot, or RVH
lab - Branching gram-positive rods with sulfur granules
Actinomyces israelii
lab - Bronchogenic apical lung tumour on imaging
Pancoast tumour - can compress sympathetic ganglion and cause horners syndrome
Or compression of C8T1 nerve roots
lab - “brown” tumour of bone
hyperparathyroidism or osteitis fibrosa cystica
- deposited haemosiderin from haemorrage gives brown colour
lab - Cardiomegaly with apical atrophy
Chagas’ disease (trypanosoma cruzi)
lab - Cellular crescents in bowman’s capsule
Rapidly progressive crescenteric GN
lab - Chocolate cyst of ovary
Endometriosis - frequently involves both ovaries
lab - Circular grouping of dark tumour cells surrounding pale neurofibrils
Homer-Wright rosettes (neuroblastoma, medulloblastoma, retinoblastoma)
lab - Colonies of mucoid pseudomonas in lungs
Cystic fibrosis (autosomal recessive mutation in CFTR resulting in fat soluble vitamin deficiency and mucous plugs)
lab - Decreased alpha-fetoprotein in amniotic fluid/maternal serum
Down Syndrome or other chromosomal abnormality
lab - Degeneration of dorsal column nerves
Tabes dorsalis (tertiary siphilis)
subacute combined degneration - dorsal columns and lateral corticospinal tracts affected
lab - depigmentation of neurons in substantia nigra
Parkinson’s disease (basal ganglia disorder - rigidity, resting tremor, bradykinesia)
lab - desquamated epithelium casts in sputum
Curschmann’s spirals - bronchial asthma –> can result in whorled mucous plugs
lab - disarrayed granulosa cells in eosinophilic fluid
Call-Exner bodies (granulosa-theca cell tumour of the ovary)
lab - Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia
Koilocytes
- HPV - predisposes to cervical cancer
lab - enlarged cells with intranuclear inclusion bodies
“Owls eyes” appearance of CMV
lab - Enlarged thyroid cells with ground-glass nuclei
“Orphan Annie’s eyes” nuclei (papillary carcinoma of the thyroid)
lab - Eosinophilic cytoplasmic inclusions in liver cells
Mallory bodies - alcoholic liver disease
lab - Eosinophilic cytoplasmic inclusion in nerve cells
Lewy body (Parkinson’s disease)
lab - Eosinophilic globule in liver
Councilman body (toxic or viral hepatitis, ften yellow fever)
lab - Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells
Negri bodies of rabies (Lyssavirus)
lab - Extracellular amyloid deposition in gray matter of brain
Senile plaques (Alzheimer’s disease)
lab - Giant B cells with bilobed nuclei with prominent inclusions
Reed-Sternberg cells (Hodgkin’s lymphoma)
lab - Glomerulus-like structure surrounding vessel in germ cells
Schiller-Duval bodies (Yolk sac tumour)
lab - “Hair on end” (crew-cut) appearance on Xray
B-thalassemia, sickle cell anaemia (marrow expansion)
lab - hCG elevated
Choriocarcinoma, hydatidiform mole (occurs with or without embryo)
lab - Heart nodules (granulomatous)
Aschoff bodies (rheumatic fever)
lab - Heterophile antibodies
Infectious mononucleosis (EBV)
lab - Hexagonal, double-pointed, needle-like crystals in bronchial secretions
Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)
lab - High levels of D-dimers
DVT, pulmonary embolism, DIC
lab - Hilar lymphandenopathy, peripheral granulomatous lesion in middle or lower lung lobes
- lesions can calcify
Ghon complex (primary TB: mycobacterium bacilli)
lab - Honeycomb lung on Xray or CT
Interstitial pulmonary fibrosis
lab - Hypercoagulability (leading to migrating DVTs and vasculitis)
Trousseau’s sign (adenocarcinoma of pancreas or lung)
lab - hypersegmented neutrophils
megaloblastic anaemia - B12 deficiency
neurologic symptoms;
Folate deficiency - no neurologic symptoms
lab - HTN, hypokalemia, metabolic alkalosis
CONN’s syndrome
lab - Hypochromic, microcytic anaemia
Fe deficency, lead poisoning, thalassemia (fetal hemaglobin sometimes present)
lab - Increased alpha-fetoprotein in amniotic fluid/maternal serum
dating error, anencephaly, spina bifida (neural tube defects)
lab - Increased uric acid levels
Gout
Lesch-Nyhan syndrome
Tumour lysis syndrome
Loop and thiazide diuretics
lab - Intranuclear eosinophilic droplet-like bodies
Cowdry type A bodies (HSV or CMV)
lab - Iron-containing nodules in alveolar septum
Ferruginous bodies (Asbestosis: incr chance of mesothelioma)
lab - Keratin pearls on skin biopsy
Squamous cell carcinoma
lab - Large lysosomal vesicles in phagocytes, immunodeficiency
Chediak-Higashi disease (congenital faiulre of phagolysosome formation)
lab - Leadpipe appearance of colon on barium enema Xray
UC - loss of haustra
lab - Linear appearance of IgG deposition on GBM
Goodpasture’s syndrome
lab - Low serum ceruloplasmin
Wilson’s disease (hepatolenticular degeneration_
lab - Lytic (“hole punched” bone lesions on Xray
multiple myeloma
lab - Mammary gland - blue domed cyst
Fibrocystic change of the breast
lab - Monoclonal Ab spike
- Multiple myeloma (IgG or IgA)
- Monoclonal gammopathy of undertermined significance (MGUS; normal consequence of aging)
- Waldenstrom’s macroglobulinaemia (Mprotein = IgM)
- primary amyloidosis
lab - Mucin-filled cell with peripheral nucleus
Signet ring (gastric carcinoma)
lab - Narrowing of bowel lumen on barium Xray
String sign- Crohn’s disease
lab - Necrotising vasculitis (lungs) and necrotising glomerulonephritis
Granulomatosis with polyangiitis (Wegeners cANCA positive)
and Goodpasture’s syndrome (anti-basement membrane antibodies)
lab - Needle-shaped, negatively birefringent crystals
Gout (monosodium urate crystals)
lab - Nodular hyaline deposits in glomeruli
Kimmelsteiel-Wilson nodules (diabetic nephropathy)
lab - Novobiocin response
Sensitive: staphylococcus epidermidis
Resistant: staphylococcus saphrophyticus
lab - Nutmeg liver
Chronic passive congestion of liver due to Right heart failure
lab - “Onion skin” periosteal reaction
Ewing’s sarcoma (Malignant round-cell tumour)
lab - Optichin response
Sensitive: Streptococcus pneumoniae
Resistant: Viridans streptococcus
lab - Periosteium raised from bone, creating triangular area
Codman’s triangle on Xray
Osteosarcoma, Ewing’s sarcoma, pyogenic osteomyelitis
lab - Podocyte fusion or effacement on electron microscopy
Minimal change disease (child with nephrotic syndrome)
lab - polished “ivory like” appearance of bone at cartilage erosion
Eburnation (osteoarthritis resulting in bony sclerosis)
lab - protein aggregates in neurons from hyperphosphorylation of protein tau
Neurofibrillary tangles (Alzheimer’s disease) and Pick’s bodies (pick’s disease)
lab - Psammoma bodies
Meningiomas
papillary thyroid carcinoma
mesothelioma
papillary serious carcinoma of the endometrium and ovary
lab - Pseudopalisading tumour cells on brain biopsy
glioblastoma multiforme
lab - RBC casts in urine
Acute glomerulonephritis
lab - rectangular, crystal like cytoplasmic inclusions in Leydig cells
Reinke crystals
Leydig cell tumour
lab - Renal epithelial casts in urine
Acute toxic/viral nephrosis
lab - Rhomboid crystals, positively birefringent
Pseudogout (calcium pyrophosphate dihydrate crystals)
lab - Rib notching
coarctation of aorta
lab - Ring enhancing brain lesion in AIDS
Toxoplasma gondii, CNS lymphoma
lab - Sheets of medium sized lymphoid cells with scattered pale, tingible body-laden macrophages (starry sky)
Burkitt’s lymphoma
t(8:14) c-myc activation associated with EBV
Black sky made up of malignant cells
lab - Silver staining spherical aggregation of tau proteins in neurons
Pick bodies (Pick’s disease - progressive dementia, changes in personality)
lab - “Soap bubble” in femur or tibia on Xray
Giant cell tumour of bone (generally benign)
lab - Spikes on basement membrane, “dome-like” subepithelial deposits
Membranous glomerulonephritis - may progress to nephrotic syndrome
lab - Stacks of RBCs
Rouleaux formation
- high ESR or Multiple myeloma
lab - Stipled vaginal epithelial cells
“Clue cells” Gardnerella vaginalis
lab - Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells
Birbeck granules (Langerhans cell histiocytosis or histiocytosis X: eosinophilic granuloma)
lab - Thrombi made of white/red layers
Lines of Zahn (arterial thrombus, layers of platelets/RBCs)
lab - “Thumb sign” on lateral Xray
Epiglottitis (haemophilus influenzae)
lab - Thyroid like appearance of kidney
Chronic bacterial pyelonephritis
lab - Tram-track appearance of capillary loops of glomerular basement membranes on light microscopy
Membranoproliferative glomerulonephritis
lab - Triglyceride accumulation in liver cell vacuoles
Fatty liver disease (alcoholic or metabolic syndrome)
lab - “Waxy” casts with very low urine flow
Chronic end stage renal disease
lab - WBC casts in urine
Acute pyelonephritis
lab - WBCs that look “smudged”
CLL - almost always B cell
lab - “Wire loop” glomerular capillary appearance on light microscopy
Lupus nephropathy
lab - Yellowish CSF
Xanthochromia (due to subarachnoid haemorrhage)
