Classic Labs/Findings Flashcards
1
Q
Anti-centromere antibodies
A
Scleroderma (CREST)
2
Q
Anti-desmoglein (anti-desmosome) antibodies
A
Pemphigus vulgaris (blistering)
3
Q
Anti-glomerular basement membrane antibodies
A
Goodpasture syndrome (glomerulonephritis and hemoptysis)
4
Q
Anti-histone antibodies
A
Drug induced SLE (eg hydralazine, isoniazid, phenytoin, procainamide)
5
Q
Anti-IgG antibodies
A
Rheumatoid arthritis (systemic inflammation, joint pannus, boutonniere deformity)
6
Q
Anti-mitochondrial antibodies (AMAs)
A
1° biliary cirrhosis (female, cholestasis, portal hypertension)
7
Q
MPO-ANCA/p-ANCA (anti-neutrophil cytoplasmic antibodies
A
Microscopic polyangiitis and eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome)
8
Q
PR3-ANCA/c-ANCA (anti-neutrophil cytoplasmic antibodies)
A
Granulomatosis with polyangiitis (Wegener’s)
9
Q
Anti-nuclear antibodies (ANAs: anti-Smith and anti-dsDNA)
A
SLE (type III HSR)
10
Q
Anti-platelet antibodies
A
Idiopathic thrombocytopenic purpura
11
Q
Anti-topoisomerase antibodies
A
Diffuse systemic scleroderma
12
Q
Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies
A
Celiac disease (diarrhea, weight loss)
13
Q
“Apple core” lesion on barium enema x-ray
A
Colorectal cancer (usually left-sided)
14
Q
Atypical lymphocytes
A
EBV
15
Q
Azurophilic peroxidase + granular inclusions in granulocytes and myeloblasts
A
Auer rods (AML, especially the promyelocytic [M3] type)
16
Q
Bacitracin response
A
Sensitive: S. pyogenes (group A); Resistant: S. agalactiae (group B)
17
Q
“Bamboo spine” on x-ray
A
Ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27)
18
Q
Basophilic nuclear remnants in RBCs
A
Howell-Jolly bodies (due to splenectomy or nonfunctional spleen)
19
Q
Basophilic stippling of RBCs
A
Lead poisoning or sideroblastic anemia
20
Q
Bloody or yellow tap on lumbar puncture
A
Subarachnoid hemorrhage
21
Q
“Boot-shaped” heart on x-ray
A
Tetralogy of Fallot (due to RVH)
22
Q
Branching gram + rods with sulfur granules
A
Actinomyces israelii
23
Q
Bronchogenic apical lung tumor on imaging
A
Pancoast tumor (can compress cervical sympathetic chain and cause Horner syndrome)
24
Q
“Brown” tumor of bone
A
Hyperparathyroidism or osteitis fibrosa cystica (deposited hemosiderin from hemorrhage gives brown color)
25
Cardiomegaly with apical atrophy
Chagas disease (Trypanosoma cruzi)
26
Cellular crescents in Bowman capsule
Rapidly progressive crescentic glomerulonephritis
27
"Chocolate cyst" of ovary
Endometriosis (frequently involves both ovaries
28
Circular grouping of dark tumor cells surrounding pale neurofibrils
Homer-Wright rosettes (neuroblastoma, medulloblastoma)
29
Colonies of mucoid Pseudomonas in lungs
Cystic fibrosis (autosomal recessive mutation in CFTR gene ➡️ fat-soluble vitamin deficiency and mucous plugs)
30
⬇️ AFP in amniotic fluid/maternal serum
Down syndrome or other chromosomal abnormalities
31
"Delta wave" on EKG, short PR interval, supraventricular tachycardia
Wolff-Parkinson-White syndrome (Bundle of Kent bypasses AV node)
32
Depigmentation of neurons in substantia nigra
Parkinson disease (basal ganglia disorder: rigidity, restin 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 neuron
Lewy body (Parkinson disease and Lewy body dementia)
41
Eosinophilic globule in liver
Councilman body (viral hepatitis, yellow fever), represents hepatocyte undergoing apoptosis
42
Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar 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's 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
β-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 (1° 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
1° hyperaldosteronism (Conn syndrome)
57
Hypochromic, microcytic anemia
Iron deficiency anemia, lead poisoning, thalassemia (fetal hemoglobin sometimes present)
58
Intranuclear eosinophilic droplet-like bodies
Cowdry type A bodies (HSV or VZV)
59
Iron-containing nodules in alveolar septum
Ferruginous bodies (asbestosis: ⬆️ chance of mesothelioma)
60
Keratin pearls on a skin biopsy
Squamous cell carcinoma
61
Large granules in phagocytes, immunodeficiency
Chediak-Higashi disease (congenital failure of phagolysosome formation)
62
"Lead pipe" appearance of colon on abdominal imaging
Ulcerative colitis (loss of haustra)
63
Linear appearnce of IgG depostion on glomerular and alveolar membranes
Goodpasture syndrome
64
⬆️ AFP in amniotic fluid/maternal serum
dating error, anencephaly, spina bifida (neural tube defect)
65
Low serum ceruloplasmin
Wilson disease (hepatolenticular degeneration)
66
"Lumpy bumpy" appearance of glomeruli on immunofluorescence
Poststreptococcal glomerulonephritis (due to deposition of IgG, IgM, and C3)
67
Lytic ("punched out") bone lesions on x-ray
Multiple myeloma
68
Mammary gland ("blue domed") cyst
Fibrocystic change of he breast
69
Monoclonal antibody spike
- Multiple myeloma (usually IgG or IgA)
- Monoclonal gammopathy of undetermined significance (MGUS consequence of aging)
- Waldenstrom (M protein = M spike) macrogloblulinemia
- 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
Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis
Granulomatosis with polyangiitis (Wegener; PR3-ANCA/c-ANCA) and Goodpasture syndrome (anti-basement membrane antibodies)
73
Needle shaped, (-) birefringent crystals
Gout (monosodium urate crystals)
74
Nodular hyaline deposits in glomeruli
Kimmelstiel-Wilson nodules (diabetic nephropathy)
75
Novobiocin response
Sensitive: S. epidermidis
Resistant: S. saprophyticus
76
"Nutmeg" appearance of liver
Chronic passive congestion of liver due to 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 streptococci (S. mutans, S. sanguis)
79
Podocyte fusion or "effacement" on electron microscopy
Minimal change disease (child with nephrotic syndrome)
80
Polished, "ivory-like" appearance of bone at cartilage erosion
Eburnation (osteoarthritis in bony sclerosis)
81
Protein aggregate in neurons from hyperphosphorylation of tau protein
Neurofibrillary tangles (Alzheimer disease) and Pick bodies (Pick disease)
82
Psammoma bodies
Meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of the endometrium and ovary
83
Pseudopalisading tumor cells on brain biopsy
Glioblastoma multiforme
84
Raised peritosteum (creating a "Codman triangle")
Aggressive bone lesion (eg osteosarcoma, Ewing sarcoma, osteomyelitis)
85
RBC casts in urine
Glomerulonephritis
86
Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells
Reinke crystals (Leydig cell tumor)
87
Recurrent infections, eczema, thrombocytopenia
Wiskott-Aldrich syndrome
88
Renal epithelial casts in urine
Intrinsic renal failure (eg ischemia or toxic injury)
89
Rhomboid crystals, + birefringent
Pseudogout (calcium pyrophosphate dihydrate crystals)
90
Rib notching (inferior surface, on x-ray)
Coarctation of the aorta
91
Ring enhancing brain lesion on CT/MRI in AIDS
Toxoplasma gondii, CNS lymphoma
92
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)
93
Silver staining spherical aggregation of tau proteins in neurons
Pick bodies (Pick disease progressive dementia, changes in personality)
94
"Soap bubble" in femur or tibia on x-ray
Giant cell tumor of bone (generally 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 frontal CXR
Croup (parainfluenza virus)
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)
102
Thrombi made of white/red layers
Lines of Zahn (arterial thrombus, layers of platelets/RBCs)
103
"Tumb sign" on lateral neck x-ray
Epiglottitis (Haemophilus influenzae)
104
Thyroid-like appearance of kidney
Chronic pyelonephritis (usually due recurrent infection)
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
⬆️ uric acid levels
Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics
108
"Waxy" casts with very low urine flow
Chronic end stage renal disease
109
WBC casts in urine
Acute pyelonephritis
110
WBCs that look "smudged"
CLL (almost always B cell)
111
"Wire loop" glomerular capillary appearance on light
Diffuse proliferative glomerulonephritis (usually seen with lupus)
112
Yellowish CSF
Xanthochromia (eg due to subarachnoid hemorrhage)
