classic labs/findings

Question 1

increased AFP in amniotic fluid/maternal serum

Answer 1

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

Question 2

anticentromere antibodies

Answer 2

scleroderma (CREST)

Question 3

anti-desmogelin (anti-desmosome) antibodies

Answer 3

pemphigus vulgaris (blistering)

Question 4

anti-glomerular basement membrane antibodies

Answer 4

Goodpasture syndrome (glomerulonephritis and hemoptysis)

Question 5

antihistone antibodies

Answer 5

drug-induced SLE (hydrazine, isoniazid, phenytoin, procainamide)

Question 6

anti-IgG antibodies

Answer 6

rheumatoid arthritis (systemic inflammation, joint panes, boutonniere deformity)

Question 7

antimitochondrial antibodies

Answer 7

primary biliary cirrhosis (female, cholestasis, portal hypertension)

Question 8

antineutrophil cytoplasmic antibodies (ANCAs)

Answer 8

microscopic polyangiitis and eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome) (MPO-ANCA/p-ANCA); granulomatosis with polyangiitis (Wegener, PR3-ANCA/c-ANCA)

Question 9

antinuclear antibodies (ANA: anti-Smith and anti-dsDNA)

Answer 9

SLE (type III hypersensitivity)

Question 10

anti platelet antibodies

Answer 10

idiopathic thrombocytopenia purpura

Question 11

anti-topoisomerase antibodies

Answer 11

diffuse systemic scleroderma

Question 12

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

Answer 12

celiac disease (diarrhea, weight loss)

Question 13

“apple core” lesion on barium enema x-ray

Answer 13

colorectal cancer (usually left-sided)

Question 14

atypical lymphocytes

Answer 14

EBV

Question 15

azurophilic peroxidase positive granular inclusions in granulocytes and myeloblasts

Answer 15

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

Question 16

Bacitracin response

Answer 16

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

Question 17

“bamboo spine” on xray

Answer 17

ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27)

Question 18

basophilic nuclear remnants in RBCs

Answer 18

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

Question 19

basophilic stippling of RBCs

Answer 19

lead poisoning or sideroblastic anemia

Question 20

bloody or yellow tap on lumbar puncture

Answer 20

subarachnoid hemorrhage

Question 21

“boot shaped” heart on xray

Answer 21

Tetralogy of Fallot (due to RVH)

Question 22

branching gram positive rods with sulfur granules

Answer 22

Actinomyces israelii

Question 23

bronchogenic apical lung tumor on imaging

Answer 23

Pan coast tumor (can compress cervical sympathetic chain and cause Horner syndrome)

Question 24

“brown” tumor of bone

Answer 24

Hyperparathyroidism or osteitis fibrous cystic (deposited hemosiderin from hemorrhage gives brown color)

Question 25

cardiomegaly with apical atrophy

Answer 25

Chugs disease (Trypanosoma cruzi)

Question 26

cellular crescents in Bowman capsule

Answer 26

rapidly progressive crescentic glomerulonephritis

Question 27

“chocolate cyst” of ovary

Answer 27

endometriosis (frequently involves both ovaries)

Question 28

circular grouping of dark tumor cells surrounding pale neurofibrils

Answer 28

Homer-Wright rosettes (neuroblastoma, medulloblastoma)

Question 29

colonies of mucoid Pseudomonas in lungs

Answer 29

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

Question 30

decreased AFP in amniotic fluid/maternal serum

Answer 30

Down syndrome or other chromosomal abnormalities

Question 31

degeneration of dorsal column fibers

Answer 31

tabes dorsalis (tertiary syphilis), subacute combined degeneration (dorsal columns, lateral corticospinal, spinocerebellar tracts affected)

Question 32

“delta wave” on EKG, short PR interval, supra ventricular tachycardia

Answer 32

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

Question 33

depigmentation of neurons in substantia nigra

Answer 33

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

Question 34

desquamated epithelium casts in sputum

Answer 34

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