Classic Labs/Findings Flashcards by Erica Lee

Classic Labs/Findings

↑ AFP in amniotic fluid/maternal serum

Dating error, anencephaly, spina bifida (neural tube defects)

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Classic Labs/Findings

Anticentromere antibodies

Scleroderma (CREST)

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Classic Labs/Findings

Anti-desmoglein (anti-desmosome) antibodies

Pemphigus vulgaris (blistering)

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Classic Labs/Findings

Anti-glomerular basement membrane antibodies

Goodpasture syndrome (glomerulonephritis and hemoptysis)

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Classic Labs/Findings

Antihistone antibodies

Drug-induced SLE (eg hydralazine, isoniazid, phenytoin, procainamide)

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Classic Labs/Findings

Anti-IgG antibodies

Rheumatoid arthritis (systemic inflammation, jint pannus, boutonniere deformity)

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Classic Labs/Findings

Antimitochondrial antibodies (AMAs)

1° biliary cirrhosis (female, cholestasis, portal hypertension)

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Classic Labs/Findings

Antineutrophil cytoplasmic antibodies (ANCAs)

Microscopic polyangitis and eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome) (MPO-ANCA/p-ANCA)
Granulomatosis with polyangiitis (Wegener) (PR3-ANCA/c-ANCA

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Classic Labs/Findings

Antinuclear antibodies (ANAs: anti-Smith & anti-dsDNA)

SLE (type III hypersensitivity)

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Classic Labs/Findings

Antiplatelet antibodies

Idiopathic thrombocytopenic purpura

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Classic Labs/Findings

Anti-topoisomerase antibodies

Diffuse systemic scleroderma

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Classic Labs/Findings

Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies

Celiac disease (diarrhea, weight loss)

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Classic Labs/Findings

“Apple core” lesion on barium enema x-ray

Colorectal cancer (usually left-sided)

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Classic Labs/Findings

Atypical lymphocytes

EBV

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Classic Labs/Findings

Azurophilic peroxidase ⊕ granular inclusions in granulocytes and myeloblasts

Auer rods (AML, especially the promyelocytic [M3] type)

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Classic Labs/Findings

Bacitracin response

Sensitive: S. pyogenes (group A)
Resistant: S. agalactiae (group B)

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Classic Labs/Findings

“Bamboo spine” on X-ray

Ankylosing spondylitis (chronic inflammatory arthritis HLA-B27)

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Classic Labs/Findings

Basophilic nuclear remnants in RBCs

Howell-Jolly bodies (due to splenectomy or nonfunctional spleen)

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Classic Labs/Findings

Basophilic stippling of RBCs

Lead poisoning or sideroblastic anemia

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Classic Labs/Findings

Bloody or yellow tap on lumbar puncture

Subarachnoid hemorrhage

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Classic Labs/Findings

“Boot-shaped” heart on X-ray

Tetralogy of Fallot (due to RVH)

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Classic Labs/Findings

Branching gram ⊕ rods with sulfur granules

Actinomyces israelii

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Classic Labs/Findings

Bronchogenic apical lung tumor on imagaing

Pancoast tumor (can compress sympathetic chain and cause Horner syndrome)

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Classic Labs/Findings

“Brown” tumor of bone

Hyperparathyroidism or osteitis fibrosa cystica (deposited hemosiderin from hemorrhage gives brown color)

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# Classic Labs/Findings Cardiomegaly with apical atrophy

Chagas disease (Trypanosoma cruzi)

# Classic Labs/Findings Cellular crescents in Bowman capsule

Rapidly progressive crescentic glomerulonephritis

# Classic Labs/Findings "Chocolate cyst" of ovary

Endometriosis (frequently involves both ovaries)

# Classic Labs/Findings Circular grouping of dark tumor cells surrounding pale neurofibrils

Homer-Wright rosettes (neuroblastoma, medulloblastoma)

# Classic Labs/Findings Colonies of mucoid Pseudomonas in lungs

Cystic fibrosis (autosomal recessive mutation in CFTR gene → fat-soluble deficiency and mucous plugs)

# Classic Labs/Findings ↓ AFP in amniotic fluid/maternal serum

Down syndrome or other chromosomal abnormalities

# Classic Labs/Findings Degeneration of dorsal column fibers

Tabes dorsalis (3° syphilis), subacute combined degeneration (dorsal columns, lateral corticospinal, spinocerebellar tracts affected)

# Classic Labs/Findings "Delta wave" on EKG, short PR interval, supraventricular tachycardia

Wolff-Parkinson-White syndrome (Bundle of Kent bypasses AV node)

# Classic Labs/Findings Depigmentation of neurons in substantia nigra

Parkinson disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia)

# Classic Labs/Findings Desquamated epithelium casts in sputum

Curschmann spirals (bronchial asthma; can result in whorled mucous plugs)

# Classic Labs/Findings Disarrayed granulosa cells arranged around collections of eosinophilic fluid

Call-Exner bodies (granulosa cell tumor of the ovary)

# Classic Labs/Findings Dysplastic squamous cervical cells with "raisinoid" nuclei and hyperchromasia

Koilocytes (HPV: predisposes to cervical cancer)

# Classic Labs/Findings Electrica alternans (alternating amplitude on EKG)

Pericardial tamponade

# Classic Labs/Findings Enlarged cells with intranuclear inclusion bodies

"Owl eye" appearance of CMV

# Classic Labs/Findings Enlarged thyroid cells with ground-glass nuclei with central clearing

"Orphan Annie" eyes nuclei (papillary carcinoma of the thyroid)

# Classic Labs/Findings Eosinophilic cytoplasmic inclusion in liver cell

Mallory body (alcoholic liver disease)

# Classic Labs/Findings Eosinophilic cytoplasmic inclusion in neuron

Lewy body (Parkinson disease & Lewy body dementia)

# Classic Labs/Findings Eosinophilic globule in liver

Councilman body (viral hepatitis, yellow fever) - represents hepatocyte undergoing apoptosis

# Classic Labs/Findings Eosinophilic inclusions bodies in cytoplasm of hippocampal and cerebellar neurons

Negri bodies of rabies

# Classic Labs/Findings Extracellular amyloid deposition in gray matter of brain

Senile plaques (Alzheimer disease)

# Classic Labs/Findings Giant B cels with bilobed nuclei with prominent inclusions ("owl's eye")

Reed-Sternberg cells (Hodgkin lymphoma)

# Classic Labs/Findings Glomerulus-like structure surrounding vessel in germ cells

Schiller-Duval bodies (yolk sac tumor)

# Classic Labs/Findings "Hair on end" ("Crew-cut") appearance on x-ray

β-thalassemia, sickle cell disease (marrow expansion)

# Classic Labs/Findings hCG elevated

Choriocarcinoma, hydatidiform mole (occurs with an without embryo, and multiple pregnancy)

# Classic Labs/Findings Heart nodules (granulomatous)

Aschoff bodies (rheumatic fever)

# Classic Labs/Findings Heterophile antibodies

Infectious mononucleosis (EBV)

# Classic Labs/Findings Hexagonal, double-pointed, needle-like crystals in bronchial secretions

Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)

# Classic Labs/Findings High level of D-dimers

DVT, PE, DIC

# Classic Labs/Findings Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify)

Ghon complex (1° TB: Mycobaterium bacilli)

# Classic Labs/Findings "Honeycomb lung" on x-ray or CT

Interstitial pulmonary fibrosis

# Classic Labs/Findings Hypercoagulability (leading to migrating DVTs and vasculitis)

Trousseau syndrome (adenocarcinoma of pancreas or lung)

# Classic Labs/Findings Hypersegmented neutrophils

Megaloblastic anemia (B12 deficiency: neurologic symptoms; folate deficiency: no neurologic symptoms)

# Classic Labs/Findings Hypertension, hypokalemia, metabolic alkalosis

1° hyperaldosteronism (Conn syndrome)

# Classic Labs/Findings Hypochromic, microcytic anemia

Iron deficiency anemia, lead poisoning, thalassemia (fetal hemoglobin sometimes present)

# Classic Labs/Findings Intranuclear eosinophilic droplet-like bodies

Cowdry type A bodies (HSV or VZV)

# Classic Labs/Findings Iron-containing nodules in alveolar sputum

Ferruginous bodies (asbetosis: ↑ chance of mesothelioma)

# Classic Labs/Findings Keratin pearls on a skin biopsy

Squamous cell carcinoma

# Classic Labs/Findings Large granules in phagocytes, immunodeficiency

Chediak-Higashi disease (congenital failure of phagolysosome formation)

# Classic Labs/Findings "Lead pipe" appearance of colon on abdominal imaging

Ulcerative colitis (loss of haustra)

# Classic Labs/Findings Linear appearance of IgG deposition on glomerular and alveolar basement membranes

Goodpasture syndrome

# Classic Labs/Findings Low serum ceruloplasmin

Wilson disease (hepatolenticular degeneration

# Classic Labs/Findings "Lumpy bumpy" appearance of glomeruli on immunofluorescence

Poststreptococcal glomerulonephritis (due to deposition of IgG, IgM, C3)

# Classic Labs/Findings Lytic ("punched out") bone lesions on x-ray

Multiple myeloma

# Classic Labs/Findings Mammary gland ("blue-domed") cyst

Fibrocystic change of the breast

# Classic Labs/Findings 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 ```

# Classic Labs/Findings Mucin-filled cell with peripheral nucleus

"Signet ring" (gastric carcinoma)

# Classic Labs/Findings Narrowing of bowel lumen on barium x-ray

"String sign" (Crohn disease)

# Classic Labs/Findings Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis

Granulomatosis with polyangiitis (Wegener; PR3-ANCA/c-ANCA) and Goodpasture syndrome (anti-basement membrane antibodies)

# Classic Labs/Findings Needle-shaped, ⊖ birefringent crystals

Gout (monosodium urate crystals)

# Classic Labs/Findings Nodular hyaline deposits in glomeruli

Kimmelstiel-Wilson nodules (diabetic nephropathy)

# Classic Labs/Findings Novobiocin response

Sensitive: S. epidermidis Resistant: S. saprophyticus

# Classic Labs/Findings "Nutmeg" appearance of liver

Chronic passive congestion of liver due to right heart failure or Budd-Chiari syndrome

# Classic Labs/Findings "Onion skin" periosteal reaction

Ewing sarcoma (malignant small blue cell tumor)

# Classic Labs/Findings Optochin response

Sensitive: S. pneumoniae Resistant: viridans streptococcii (S. mutans, S. sanguis)

# Classic Labs/Findings Podocyte fusion or "effacement" on electron microscopy

Minimal change disease (child with nephrotic syndrome)

# Classic Labs/Findings Polished, "ivory-like" appearance of bone at cartilage erosion

Eburnation (osteoarthritis resulting in bony sclerosis)

# Classic Labs/Findings Protein aggregates in neurons from hyperphosphorylation of tau protein

Neurofibrillary tangles (Alzheimer disease ) and Pick bodies (Pick disease)

# Classic Labs/Findings Psammoma bodies

Meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of the endometrium and ovary

# Classic Labs/Findings Pseudopalisading tumor cells on brain biopsy

Gliobastoma multiforme

# Classic Labs/Findings Raised periosteum (creating a "Codman triangle")

Aggressive bone lesion (e.g. osteosarcoma, Ewing sarcoma, osteomyelitis)

# Classic Labs/Findings RBC casts in urine

Glomerulonephritis

# Classic Labs/Findings Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells

Reinke crystals (Leydig cell tumor)

# Classic Labs/Findings Recurrent infections, eczema, thrombocytopenia

Wiskott-Aldrich syndrome

# Classic Labs/Findings Renal epithelial casts in urine

Intrinsic renal failure (e.g. ischemia or toxic injury)

# Classic Labs/Findings Rhomboid crystals, ⊕ birefringent

Pseudogout (calcium pyrophosphate dihydrate crystals)

# Classic Labs/Findings Rib notching (inferior surface, on x-ray

Coarctation of the aorta

# Classic Labs/Findings Ring-enhancing brain lesion on CT/MRI in AIDS

Toxoplasma gondii, CNS lymphoma

# Classic Labs/Findings 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)

# Classic Labs/Findings Silver-staining spherical aggregation of tau proteins in neurons

Pick bodies (Pick disease: progressive dementia, changes in personality)

# Classic Labs/Findings "Soap bubble" in femur or tibia on x-ray

Giant cell tumor of bone (generally benign)

# Classic Labs/Findings "Spikes" on basement membrane, "dome-like" subepithelial deposits

Membranous nephropathy (nephrotic syndrome)

# Classic Labs/Findings Stacks of RBCs

Rouleaux formation (high ESR, multiple myeloma)

# Classic Labs/Findings "Steeple" sign on frontal CXR

Croup (parainfluenza virus)

# Classic Labs/Findings Stippled vaginal epithelial cells

"Clue cells" (Gardnerella vaginalis)

# Classic Labs/Findings Streptococcus bovis bacteremia

Colon cancer

# Classic Labs/Findings "Tennis racket"-shaped cytoplasmic organelles (EM) in Langerhans cells

Birbeck granules (Langerhans cell histocytosis)

# Classic Labs/Findings Thousands of polyps on colonoscpy

Familial adenomatous polyposis (autosomal dominant, mutation of APC gene)

# Classic Labs/Findings Thrombi made of white/red layers

Lines of Zahn (arterial thrombus, layers of platelets/RBCs)

# Classic Labs/Findings "Thumb sign" on lateral neck x-ray

Epiglottitis (Haemophilus influenzae)

# Classic Labs/Findings Thyroid-like appearance of kidney

Chronic pyelonephritis (usually due to recurrent infection)

# Classic Labs/Findings "Tram-track" appearance of capillary loops of glomerular basement membrane on light microscopy

Membranoproliferative glomerulonephritis

# Classic Labs/Findings Triglyceride accumulation in liver cell vacuoles

Fatty liver disease (alcoholic or metabolic syndrome)

# Classic Labs/Findings ↑ uric acid levels

Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics

# Classic Labs/Findings "Waxy" casts with very low urine flow

Chronic end-stage renal disease

# Classic Labs/Findings WBC casts in urine

Acute pyelonephritis

# Classic Labs/Findings WBCs that look "smudged"

CLL (almost always B cell)

# Classic Labs/Findings "Wire loop" glomerular capillary appearance on light microscopy

Diffuse proliferative glomerulonephritis (usually seen with lupus)

# Classic Labs/Findings Yellowish CSF

Xanthochromia (e.g. due to subarachnoid hemorrhage)