Classic Labs/Findings Flashcards
1
Q
Anticentromere antibodies
A
Scleroderma (CREST)
2
Q
Anti-desmoglein (epithelial antibodies)
A
Pemphigus vulgaris (blistering)
3
Q
Anti-GBM antibodies
A
Goodpasture syndrome (glomerulonephritis and hemoptysis)
4
Q
Anti-histone antibodies
A
Drug-induced SLE (e.g. hydralazine, isoniazid, phenytoin, procainamide)
5
Q
Anti-IgG antibodies
A
Rheumatoid arthritis (systeimc inflammation, joint pannus, boutonnière deformity)
6
Q
Anti-mitochondrial antibodies (AMAs)
A
Primary biliary cirrhosis (female, cholestasis, portal HTN)
7
Q
Antineutrophil cytoplasmic antibodies (ANCAs)
A
Microscopic polyangiitis and eosinophilic granulomatosis wiht polyangiitis (Churg-Strauss syndrome; MPO-ANCA/p-ANCA); Granulomatosis with polyangiitis (Wegener; PR3-ANCA/c-ANCA)
8
Q
Antinuclear antibodies (ANAs: 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 sclerosis
11
Q
Anti-transgultaminase/anti-gladin/anti-endomysial antibodies
A
Celiac disease (diarrhea, weight loss)
12
Q
“Apple core” lesion on barium enema x-ray
A
Colorectal cancer, usually left-sided
13
Q
Atypical lymphocytes
A
EBV
14
Q
Azurophilic peroxidase positive granular inclusions of granulocytes and myeloblasts
A
Auer rods (AML, especially the promyelocytic [M3] subtype)
15
Q
Bacitracin response
A
Sensitive: S. pyogenes (group A), resistant: S. agalactiae (group B)
16
Q
“Bamboo spine” on x-ray
A
Ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27)
17
Q
Basophilic nuclear remnants in RBCs
A
Howell-Jolly bodies (2/2 splenectomy or non-functional spleen [e.g. SCD])
18
Q
Bloody or yellow tap on lumbar puncture
A
Subarachnoid hemorrhage
19
Q
“Boot-shaped” heart on x-ray
A
Tetralogy of Fallot (2/2 RVH)
20
Q
Branching gram positive rods with sulfur granules
A
Actinomyces
21
Q
Bronchogenic apical lung tumor on imaging
A
Pancoast tumor (can compress cervical sympathetic chain and cause Horner’s syndrome)
22
Q
“Brown” tumor of bone
A
Hyperparathyroidism or osteitis fibosa cystica (deposited hemosiderin from hemorrhage gives brown color)
23
Q
Cardiomegaly with apical atrophy
A
Chagas disease (Trypanosoma cruzi)
24
Q
Cellular crescents in Bowman capsule
A
Rapidly progressing (crescentic) glomerulonephritis
25
"Chocolate cyst" of ovary
Endometriosis (frequently bilateral)
26
Circular grouping of dark tumor cells surrounding pale neurofibrils
Homer-Wright rosettes (neuroblastoma, medulloblastoma)
27
Colonies of mucoid Pseudomonas in lungs
Cystic fibrosis (autosomal recessive mutation in CFTR gene -> fat-soluble vitamin deficiency and mucous plugs)
28
Decreased AFP in amniotic fluid/maternal serum
Down syndrome or other chromosomal abnormalities
29
Degeneration of dorsal column fibers
Tabes dorsalis (tertiary syphilis), subacute combined degeneration (dorsal columns, lateral corticospinal, spinocerebellar tracts affected)
30
"Delta wave" on EKG, short PR interval, supraventricular tachycardia
Wolf-Parkinson-White syndrome (Bundle of Kent bypasses AV node)
31
Depigmentation of neurons in substantia nigra
Parkinson disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia)
32
Desquamated epithelium casts in sputum
Curschmann spirals (bronhial asthma; can result in whorled mucous plugs)
33
Disarrayed granulosa cells arranged around collections of eosinophilic fluid
Call-Exner bodies (granulosa cell tumor of the ovary)
34
Dysplastic squamous cervical cells with "raisinoid" nuclei and hyperchromasia
Koilocytes (HPV: predisposes to cervical cancer)
35
Electrical alternans (alternating amplitude on EKG)
Pericardial tamponade
36
Enlarged cells with intranuclear inclusion bodies
"Owl eye" appearance of CMV
37
Enlarged thyroid cells with ground-glass nuclei with central clearing
"Orphan Annie" eyes (papillary thyroid carcinoma)
38
Eosinophilic cytoplasmic inclusion in liver cell
Mallory body (alcoholic liver disease)
39
Eosinophilic cytoplasmic inclusion in nerve cell
Lewy body (Parkinson disease)
40
Eosinophilic globule in liver
Councilman body (viral hepatitis, yellow fever), represents hepatocyte undergoing apoptosis
41
Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar neurons
Negri bodies of rabies
42
Extracellular amyloid deposition in gray matter of brain
Senile plaques (Alzheimer)
43
Giant B cells with bilobed nuclei wiht prominent inclusions ("owl's eye")
Reed-Sternberg cells (Hodgkin lymhoma)
44
Glomerulus-like structure surrounding vessel in germ cell
Schiller-Duval bodies (yolk sac tumor)
45
"Hair on end" ("Crew-cut") appearance on x-ray
Beta-thalassemia, sickle cell disease (marrow expansion)
46
hCG elevated
Choriocarcinoma, hydatidifirom mole (occurs with and w/o embryo, and multiple pregnancy)
47
Heart nodules (granulomatous)
Aschoff bodies (rheumatic fever)
48
Heterophile antibodies
Infectious mononucleosis (EBV)
49
Hexagonal, double-pointed, needle-like crystals in bronchial secretions
Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)
50
High levels of D-dimers
DVT, PE, DIC
51
Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify
Ghon complex (1º TB: Mycobacterium bacilli)
52
"Honeycomb lung" on x-ray or CT
Interstitial pulmonary fibrosis
53
Hypercoagulability (leading to migrating DVTs and vasculitis)
Trousseau syndrome (adenocarcinoma of pancreas or lung)
54
Hypersegmented neutrophils
Megaloblastic anemia (B12 deficiency: neurologic sx, folate deficiency: no neuro sx)
55
Hypertension, hypokalemia, metabolic alkalosis
Conn syndrome (primary hyperaldosterone)
56
Hypochromic, microcytic anemia
Iron-deficiency anemia, lead poisoning, thalassemia (fetal hemoglobin sometimes present)
57
Infreased AFP in amniotic fluid/maternal serum
Dating error, anencephaly, spina bifida (neural tube defects)
58
Increased uric acid levels
Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics
59
Intranuclear eosinophilic droplet-like bodies
Bowdry type A bodies (HSV or VZV)
60
Iron-containing nodules in alveolar septum
Ferruginous bodies (asbestosis: increased chance of mesothelioma)
61
Keratin pearls on a skin biopsy
Squamous cell carcinoma
62
Large granules in phagocytes, immunodeficiency
Chédiak-Higashi disease (congenital failure of phagolysosome formation)
63
"Lead pipe" appearance of colon on abdominal imaging
Ulcerative colitis (loss of haustra)
64
Linear appearance of IgG deposition on glomerular and alveolar basement membreanes
Goodpasture syndrome
65
Low cerum ceruloplasmin
Wilson disease (hepatolenticular degeneration; Kaiser-Flescher rings in cornea)
66
"Lumpy bumpy" appearance of glomeruli on immunofluorescence
Post streptococcal glomerulonephritis (deposition of IgG, IgM, and C3)
67
Lytic ("punched out") bone lesions on x-ray
Multiple myeloma
68
Mammary gland ("blue domed") cyst
Fibrocystic changes of breast
69
Monoclonal antibody spike
Multiple myeloma (usually IgG or IgA), monoclonal gammopathy of undetermined significance (MGUS consequence of aging), Waldenstrom (M protein = IgM) macroglobulinemia, primary amyloidosis
70
Mucin filled cell with peripheral nucleus
"Signet ring" gastric carcinoma
71
Narrowing of bowel lumen on barium x-ray
"String sign" (Crohn disease)
72
Needle-shaped negatively birefringent crystals
Gout (monosodium urate crystals)
73
Nodular hyaline deposits in glomeruli
Kimmelsteil-Wilson nodules (diabetic nephropathy)
74
Necrotizing v asculitis (lungs) and glomerulonephritis
Granulomatosis with polyangiitis (Wegener; PR3-ANCA/c-ANCA) and Goodpasture syndrome (anti-GBM)
75
Novobiocin response
Sensitive: S. epidermidis; resistant: S. saprophyticus
76
"Nutmeg" appearance of liver
Chronic passive congestion 2/2 right heart failure or Budd-Chiari syndrome
77
"Onion skin" periosteal reaction
Ewing sarcoma (malignant small blue cell tumor)
78
Optochin response
Sensitive: S. pneumoniae; resistant: viridans (S. mutans, S. sanguis)
79
Periosteum raised from bone, creating triangular area
Codman triangle on x-ray, Ewing sarcoma, pyogenic osteomyelitis
80
Podocyte fusion or effacement on electron microscopy
Minimal chance disease (Child with nephrotic syndrome)
81
Polished, "ivory-like" appearance of bone at cartilage erosion
Eburnation (osteoarthritis resulting in bony sclerosis)
82
Protein aggregates in neurons from hyperphosphorylation of tau protein
Neurofibrillary tangles (Alzheimer disease) and Pick bodies (Pick disease)
83
Psammoma bodies
Meningiomas, papillary thyroid
| carcinoma, mesothelioma, papillary serous carcinoma of the endometrium and ovary
84
Pseudo-palisading tumor cells on brain biopsy
Glioblastoma multiforme
85
RBC casts in urine
Glomerulonephritis
86
Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells
Reinke crystals (Leydig cell tumor)
87
Recurrent infectious, eczema, thrombocytopenia
Wiskott-Aldrich syndrome
88
Renal epithelial casts in urine
Intrinsic renal failure (ischemia or toxic injury)
89
Rhomboid crystals, positively birefringent
Pseudogout (calcium pyrophosphate dihydrate crystals)
90
Rib notching
Coarctation of the aorta
91
Ring-enhancing lesions in AIDS
Toxoplasma, CNS lymphoma
92
Sheets of medium-sized lymphoid cells with scattered pale, tingible body-laden macrophages ("starry sky" histology)
Burkitt's lymphoma (t[8;14] c-myc-IgH, association with EBV)
93
Silver-staining spherical aggregation of tau proteins in neruons
Pick bodies (Pick disease: progressive dementia, changes in personality)
94
"Soap bubble" in femur or tibia on x-ray
Giant cell tumor of bone (usually benign)
95
"Spikes" on basement membrane, "dome-like" subepithelial deposits
Membranous nephropathy (nephrotic syndrome)
96
Stacks of RBCs
Rouleaux formation (high ESR, multiple myeloma)
97
"Steeple" sign on CXR
Croup (parainfluenza)
98
Stippled vaginal epithelial cells
"Clue cells" (Gardnerella vaginalis)
99
Streptococcus bovis bacteremia
Colon cancer
100
"Tennis racket"-shaped cytoplasmic organelles (EM) in Langerhans cells
Birbeck granules (Langerhans cell histiocytosis)
101
Thousands of polyps on colonoscopy
Familial adenomatous polyposis (autosomal dominant, mutation of APC gene, tumor suppressor)
102
Thrombi made of white/red layers
Lines of Zahn (rterial thrombus, layers of platelets/RBCs)
103
"Thumb sign" on lateral neck x-ray
Epiglottitis (Haemophilus influenzae)
104
Thyroid-like appearance of kidney
Chronic pyelonephritis (2/2 recurrent infx)
105
"Tram track" appearance of capillary loops of glomerular basement membranes on light microscopy
Membranoproliferative glomerulonephritis
106
Triglyceride accumulation in liver cell vacuoles
Fatty liver disease (alcoholic or metabolic syndrome)
107
"Waxy" casts with very low urine flow
Chronic ESRD
108
WBC casts in urine
Acute pyelonephritis or interstitial nephritis
109
WBCs that look smudged
CLL (almost always B cell)
110
"Wire loop" glomerular capillary appearance on light microscopy
Diffuse proliferative glomerulonephritis (usually seen with SLE)
111
Yellowish CSF
Xanthochromia (2/2 SAH)
112
Differentiating gram positive cocci
No Stress (Novobiocin, saphrophyticus is resistant, epidermidis is sensitive); Overpass (optochin, viridins is resistant, pneumonia is sensitive); B-BRAS (bacitracin, GBS is resistant, GAS is sensitive)
113
Lactose fermenters
Pink on MacConkey agar; "Lactose is key" - Citrobacter, klebsiella, E. coli, enterobacter, serratia)
114
Lactose non-fermenters
White colonies on MacConkey agar; Pseudomonas, Salmonella, Shigella, Proteus
115
Lactose non-fermenters, oxidase positive
Pseudomonas
116
Lactose non-fermenters, oxidase negative
Salmonella, Shigella, Proteus
117
Lactose non-fermenters, oxidase negative, no H2S production on triple sugar iron agar
Shigella
118
Lactose non-fermenters, oxidase negative, + H2S production on triple sugar iron agar
Black colonies on MacConkey agar; Salmonella, Proteus
119
Enveloped virus with phospholipid bilayer for nuclear membrane
Hepevirus - CMV
120
Enveloped virus with nuclear membrane w/o phospholipids
Flaviviurs - HCV, paramyxovirus - Mumps
121
Reservoir for schistosomiasis
Snails
