Classic labs/findings Flashcards
1
Q
anticentromere antibodies
A
scleroderma (CREST)
2
Q
anti-desmoglein (epithelial antibodies)
A
pemphigus vulgaris (blistering)
3
Q
anti-glomerular basement membrane antibodies
A
goodpasture syndrome (glomerulonephritis and hemoptysis)
4
Q
antihistone antibodies
A
drug-induced SLE (e.g., hydralazine, isoniazid, phenytoin, procainamide)
5
Q
anti-IgG antibodies
A
Rheumatoid arthritis (systemic inflammation, joint pannus, boutonniere deformity)
6
Q
antimitochondrial antibodies (AMAs)
A
Primary biliary cirrhosis (female, cholestasis, portal hypertension)
7
Q
antineutrophil cytoplasmic antibodies (ANCAs)
A
Microscopic polyangiitis and eosinophilic granulomatosis with polyangiitis (churg-strauss syndrome) (MPO-ANCA/p-ANCA);
granulomatosis with polyangiitis (wegener; PR3-ANCA/c-ANCA)
8
Q
Antinucleur 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 scleroderma
11
Q
anti-transflutaminase/anti-gliadin/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 in granulocytes and myeloblasts
A
Auer rods (AML, especially the promyelocytic [M3] type)
15
Q
bacitracin reponse
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 (due to splenectomy or nonfunctional spleen)
18
Q
basophilic strippling of RBCs
A
lead poisoning or sideroblastic anemia
19
Q
bloody or yellow tap on lumbar puncture
A
subarachnoid hemorrhage
20
Q
“Boot-shaped” heart on x-ray
A
tetralogy of fallot (due to RVH)
21
Q
branching gram-positive rods with sulfur granules
A
Actinomyces israelii
22
Q
bronchogenic apical lung tumor on imaging
A
pancoast tumor (can compress cervical sympathetic chain and cause horner tumor)
23
Q
“brown” tumor of bone
A
hyperparathyroidism or osteitis fibrosa cystica (deposited hemosiderin from hemorrhage gives brown color)
24
Q
cardiomegaly with apical atrophy
A
chagas disease (trypanosoma cruzi)
25
cellular crescents in bowman capsule
rapidly progressive crescentic glomerulonephritis
26
"chocolate cyst" of ovary
endometriosis (frequently involved both ovaries)
27
circular grouping of dark tumor cells surrounding pale neurofibrils
homer-wright rosettes (neuroblastoma, medulloblastoma)
28
colonies of mucoid pseudomonas in lungs
cystic fibrosis (autosomal recessive mutation in CFTR gene -->fat soluble vitamin deficiency and mucous plugs)
29
decrease AFP in amniotic fluid/maternal serum
down syndrome or other chromosomal abnormalities
30
degeneration of dorsal column fibers
tabes dorsalis (tertiary syphilis), subacute combined degeneration (dorsal columns, lateral corticospinal, spinocerebellar tracts affected)
31
"delta wave" on EKG, short PR interval, supraventricular tachycardia
wolf-parkinson-white syndrome (bundle of kent bypasses AV node)
32
depigmentation of neurons in substantia nigra
parkinson disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia)
33
desquamated epithelium casts in sputum
curschmann spirals (bronchial asthma; can result in whorled mucous plugs)
34
disarrayed granulosa cells arranged around collections of eosinophilic fluid
Call-Exner bodies (granulosa cell tumor of the ovary)
35
Dysplastic squamous cervical cells with "raisinoid" nuclei and hyperchromasia
Koilocytes (HPV: predisposes to cervical cancer)
36
Electrical alternans (alternating amplitude on EKG)
pericardial tamponade
37
enlarged cells with intranuclear inclusion bodies
"owl eye" appearance of CMV
38
enlarged thyroid cells with ground-glass nuclei with central clearing
"orphan annie" eyes nuclei (papillary carcinoma of the thyroid)
39
eosinophilic cytoplasmic inclusion in liver cell
mallory body (alcoholic liver disease)
40
eosinophilic cytoplasmic inclusion in nerve cells
lewy body (parkinson disease)
41
eosinophilic globule in liver
councilman body (viral hepatitis, yellow fever), represents hepatocyte undergoing apoptosis
42
eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebelar neurons
negri bodies of rabies
43
extracellular amyloid deposition in gray matter of brain
senile plaques (alzheimer disease)
44
Giant B cells with bilobed nuclei with prominent inclusions ("owl eye")
Reed-sternberg cells (hodgkin lymphoma)
45
glomerulus-like structure surrounding vessel in germ cells
schiller-duval bodies (yolk sac tumor)
46
"hair on end" ("crew cut") appearance on x-ray
Beta-thalassemia, sickle cell disease (marrow expansion)
47
hCG elevated
choriocarcinoma, hydatidiform mole (occurs with and without embryo, and multiple pregnancy)
48
heart nodules (granulomatous)
aschoff bodies (rheumatic fever)
49
heterophile antibodies
infectious mononucleosis (EBV)
50
hexagonal, double-pointed, needle-like crystals in bronchial secretions
bronchial asthma (charcot-leyden crystals: eosinophilic granules)
51
high level of D-dimers
DVT, PE, DIC
52
hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Ghon complex (primary TB: mycobacterium bacilli)
53
"Honeycomb lung" on x-ray or CT
Interstitial pulmonary fibrosis
54
hypercoagulability (leading to migrating DVTs and vasculitis)
trousseau syndrome (adenocarcinoma of pancreas or lung)
55
hypersegmented neutrophils
megaloblastic anemia (B12 deficiency: neurologic symptoms; folate deficiency: no neurologic symptoms)
56
Hypertension, hypokalemia, metabolic alkalosis
Conn syndrome (primary hyperaldosteronism)
57
hypochromic, microcytic anemia
Iron deficiency anemia, lead poisoning, thalassemia (fetal hemoglobin sometimes present)
58
increased AFP in amniotic fluid/maternal serum
dating error, anencephaly, spina bifida (neural tube defects
59
increased uric acid levels
Gout, lesch-nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics
60
intranuclear eosinophilic droplet-like bodies
cowdry type A bodies (HSV or VZV)
61
iron-containing nodules in alveolar septum
ferruginous bodies (asbestosis: increased chance of mesothelioma)
62
keratin pearls on skin biopsy
squamous cell carcinoma
63
large granules in phagocytes, immunodeficiency
chediak-higashi disease (congenital failure of phagolysosome formation)
64
"lead pipe" appearance of colon on abdominal imaging
Ulcerative Colitis (loss of haustra)
65
Linear appearance of IgG deposition on glomerular and alveolar basement membranes
goodpasture syndrome
66
low serum ceruloplasmin
wilson disease (hepatolenticular degeneration)
67
"Lumpy bumpy" appearance of glomeruli on immunofluorescence
poststreptococcal glomerulonephritis (due to deposition of IgG, IgM, and C3)
68
lytic ("punched out") bone lesions on x-ray
multiple myeloma
69
mammary gland ("blue domed") cyst
fibrocystic change of the breast
70
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
```
71
mucin-filled cell with peripheral nucleus
"signet ring" (gastric carcinoma)
72
narrowing of bowel lumen on barium x-ray
"String sign" (crohn disease)
73
necrotizing vasculitis (lungs) and necrotizing glomerulonephritis
granulomatosis with polyangiitis (wegener: PR3-ANCA/c-ANCA) and goodpasture syndrome (anti-basement membrane antibodies)
74
needle-shaped, negatively birefringent crystals
gout (monosodium urate crystals)
75
nodular hyaline deposits in glomeruli
kimmelstiel-wilson nodules (diabetic nephropathy)
76
novobiocin response
sensitive: S. epidermidis;
resistant: s. saprophyticus
77
"nutmeg" appearance of liver
chronic passive congestion of liver due to right heart failure or budd-chiari syndrome
78
"onion skin" periosteal reaction
ewing sarcoma (malignant small blue cell tumor)
79
optochin response
sensitive: s. pneumoniae;
resistant: viridans streptococci (s. mutans, S. sanguis)
80
periosteum raised from bone, creating triangular area
codman triangle on x-ray, ewing sarcoma, pyogenic osteomyelitis
81
podocyte fusion or "effacement" on electron microscopy
minimal change disease (child with nephrotic syndrome)
82
polished, "ivory-like" appearance of bone at cartilage erosion
eburnation (osteoarthritis resulting in bony sclerosis)
83
protein aggregates in neurons from hyperphosphorylation of tau protien
neurofibrillary tangles (alzheimer disease) and pick bodies (pick disease)
84
psammoma bodies
meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of the endometrium and ovary
85
pseudopalisading tumor cells on brain biopsy
glioblastoma multiforme
86
RBC casts in urine
glomerulonephritis
87
rectangular, crystal-like, cytoplasmic inclusions in leydig cells
Reinke crystals (leydig cell tumor)
88
recurrent infections, eczema, thrombocytopenia
wiskott-aldrich syndrome
89
renal epithelial casts in urine
intrinsic renal failure (e.g. ischemia or toxic injury)
90
rhomboid crystals, positively birefringent
pseudogout (calcium pyrophosphate dihydrate crystals)
91
rib notching
coarctation of the aorta
92
ring-enhancing brain lesion in AIDS
toxoplasma gondii, CNS lymphoma
93
sheets of medium-sized lymphoid cells with scattered pale, tingible body-laden macrophages ("starry sky" histology)
burkitt lymphoma (t[8:14] c-myc activation, associated with EBV; "Starry sky" made up of malignant cells)
94
silver-staining spherical aggregation of tau proteins in neurons
pick bodies (pick disease: progressive dementia, changes in personality)
95
"soap bubble" in femur or tibia on x-ray
giant cell tumor of bone (generally benign)
96
"spikes" on basement membrane, "dome-like" subepithelial deposits
membranous nephropathy (nephrotic syndrome)
97
stacks of RBCs
Rouleaux formation (high ESR, multiple myeloma)
98
"Steeple" sign on CXR
croup (parainfluenza virus)
99
strippled vaginal epithelial cells
"clue cells" (gardnerella vaginalis)
100
streptococcus bovis bacteremia
colon cancer
101
"tennis racket" - shaped cytoplasmic organelles (EM) in langerhans cells
birbeck granules (langerhans cell histiocytosis)
102
thousands of polyps on colonoscopy
familial adenomatous polyposis (autosomal dominant mutation of APC gene)
103
thrombi made of white/red layers
lines of zahn (arterial thrombus, layers of platelets/RBC)
104
"thumb sign" on lateral neck x-ray
epiglottitis (haemophilus influenzae)
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 end-stage renal disease
108
WBC casts in urine
acute pyelonephritis
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 lupus)
111
yellowish CSF
xanthochromia (e.g. due to subarachnoid hemorrhage)
