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Classic Labs/Findings Flashcards

1
Q

Increased AFP in amniotic fluid/maternal fluid

A

Dating error
Anencephaly
Spina bifida (neural tube defects)

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2
Q

Anticentromere antibodies

A

Scleroderma (CREST)

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3
Q

Anti-desmoglein (anti-desmosome) antibodies

A

Pemphigus vulgaris (blistering)

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4
Q

Anti-glomerular basement membrane antibodies

A

Goodpasture syndrome

glomerulonephritis and hemoptysis

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5
Q

Antihistone antibodies

A

Drug-induced SLE

hydralazine, isoniazid, phenytoin, procainamide

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6
Q

Anti-IgG antibodies

A 
Rheumatoid arthritis 
(systemic inflammation, joint pannus, boutonniere deformity)
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7
Q

Antimitochondrial antibodies (AMAs)

A

1ry biliary cirrhosis

female, cholestasis, portal hypertension

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8
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)

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9
Q

Antinuclear antibodies

ANAs; anti-Smith and anti-dsDNA

A

SLE (type III hypersensitivity)

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10
Q

Antiplatelet antibodies

A

Idiopathic thrombocytopenic purpura

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11
Q

Anti-topoisomerases antibodies

A

Diffuse systemic scleroderma

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12
Q

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

A

Celiac disease

diarrhea, weight loss

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13
Q

“Apple core” lesion on barium enema x-ray

A

Colorectal cancer (usually left-sided)

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14
Q

Atypical lymphocytes

A

EBV

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15
Q

Azurophilic peroxidase + granular inclusions in granulocytes and myeloblasts

A 
Auer rods 
(AML, especially the promyelocytic [M3] type)
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16
Q

Bacitracin response

A

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

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17
Q

“Bamboo spine” on x-ray

A

Ankylosing spondylitis

chronic inflammation arthritis: HLA-B27

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18
Q

Basophilic nuclear remnants in RBCs

A

Howell-Jolly bodies

due to splenectomy or nonfunctional spleen

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19
Q

Basophilic stippling of RBCs

A

Lead poisoning or sideroblastic anemia

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20
Q

Bloody or yellow tap on lumbar puncture

A

Subarachnoid hemorrhage

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21
Q

“Boot-shaped” heart on x-ray

A

Tetralogy of Fallot (due to RVH)

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22
Q

Branching gram + rods in sulfur granules

A

Actinomyces israelii

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23
Q

Bronchogenic apical lung tumor on imaging

A

Pancoast tumor

can compress cervical sympathetic chain and cause Horner syndrome

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24
Q

“Brown” tumor of bone

A

Hyperparathyroidism or osteitis fibrosa cystica

deposited hemosiderin from hemorrhage gives brown color

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25
Q

Cardiomegaly with apical atrophy

A

Chagas disease

Trypanosoma cruzi

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26
Q

Cellular crescents in Bowman capsule

A

Rapidly progressive crescentic glomerulonephritis

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27
Q

“Chocolate cyst” of ovary

A

Endometriosis

frequently involves both ovaries

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28
Q

Circular grouping of dark tumor cells surrounding pale neurofibrils

A

Homer-Wright rosettes

neuroblastoma, medulloblastoma

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29
Q

Colonies of mucoid Pseudomonas in lungs

A 
Cystic fibrosis 
(autosomal recessive mutation in CFTR gene --> fat-soluble vitamin deficiency and mucous plugs)
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30
Q

Decrease AFP in amniotic fluid/maternal serum

A

Down syndrome or other chromosomal abnormalities

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31
Q

Degeneration of dorsal column fibers

A 
Tabes dorsalis (3ry syphilis)
Subacute combined degeneration (dorsal columns, lateral corticospinal, spinocerebellar tracts affected)
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32
Q

“Delta wave” in EKG
Short PR interval
Supraventricular tachycardia

A

Wolff-Parkinson-White syndrome

Bundle of Kent bypasses AV node

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33
Q

Depigmentation of neurons in substantia nigra

A

Parkinson disease

basal ganglia disorder: rigidity, resting tremor, bradykinesia

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34
Q

Desquamated epithelium casts in sputum

A

Curschmann spirals

bronchial asthma; can result in whorled mucous plugs

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35
Q

Disarrayed granulosa cells arranged around collections of eosinophilic fluid

A

Call-Exner bodies (granulosa cell tumor of ovary)

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36
Q

Dysplastic squamous cervical cells with “raisinoid” nuclei and hyperchromasia

A

Koilocytes (HPV: predisposes to cervical cancer)

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37
Q

Electrical alternans (alternating amplitude on EKG)

A

Pericardial tamponade

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38
Q

Enlarged cells with intranuclear inclusion bodies

A

“Owl eye” appearance of CMV

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39
Q

Enlarged thyroid cells with ground-glass nuclei with central clearing

A

“Orphan Annie” eyes nuclei (papillary carcinoma of the thyroid)

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40
Q

Eosinophilic cytoplasmic inclusion in liver cell

A

Mallory body (alcoholic liver disease)

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41
Q

Eosinophilic cytoplasmic inclusion in neuron

A

Lewy body (Parkinson disease and Lewy body dementia)

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42
Q

Eosinophilic globule in liver

A

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

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43
Q

Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar neurons

A

Negri bodies of rabies

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44
Q

Extracellular amyloid deposition in grey matter of brain

A

Senile plaques (Alzheimer disease)

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45
Q

Giant B cells with bilobed nuclei with prominent inclusions (owl’s eye)

A

Reed-Sternberg cells (Hodgkin lymphoma)

46
Q

Glomerulus-like structure surrounding vessel in germ cells

A

Schiller-Duval bodies (yolk sac tumor)

47
Q

“Hair on end” (“Crew-cut”) appearance on x-ray

A

B-thalassemia, sickle cell disease (marrow expansion)

48
Q

hCG elevated

A

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

49
Q

Heart nodules (granulomatous)

A

Aschoff bodies (rheumatic fever)

50
Q

Heterophile antibodies

A

Infectious mononucleosis (EBV)

51
Q

Hexagonal, double-pointed, needle-like crystals in bronchial secretions

A

Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)

52
Q

High level of D-dimers

A

DVT, PE, DIC

53
Q

Hilar lymphadenopathy

Peripheral granulomatous lesions in middle or lower lung lobes (can calcify)

A

Ghon complex (1ry TB: Mycobacterium bacilli)

54
Q

“Honeycomb lung” on x-ray or CT

A

Interstitial pulmonary fibrosis

55
Q

Hypercoagulability (leading to migrating DVTs and vasculitis)

A

Trousseau syndrome (adenocarcinoma of pancreas or lung)

56
Q

Hyper segmented neutrophils

A

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

57
Q

Hypertension
Hypokalemia
Metabolic alkalosis

A

1ry hyperaldosteronism (Conn syndrome)

58
Q

Hypochromic, microcytic anemia

A

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

59
Q

Intranuclear eosinophilic droplet-like bodies

A

Cowry type A bodies (HSV or VZV)

60
Q

Iron-containing nodules in alveolar septum

A

Ferruginous bodies (asbestosis: increase chance of mesothelioma)

61
Q

Keratin pearls on a skin biopsy

A

Squamous cell carcinoma

62
Q

Large granules in phagocytes

Immunodeficiency

A

Chédiak-Higashi disease (congenital failure of phagolysosome formation)

63
Q

“Lead-pipe” appearance of colon on abdominal imaging

A

Ulcerative colitis (loss of haustra)

64
Q

Linear appearance of IgG deposition on glomerular and alveolar basement membranes

A

Goodpasture syndrome

65
Q

Low serum ceruloplasmin

A

Wilson disease (hepatolenticular degeneration)

66
Q

“Lumpy bumpy” appearance of glomeruli on immunofluorescence

A

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

67
Q

Lytic (“punched-out”) bone lesions on x-ray

A

Multiple myeloma

68
Q

Mammary gland (“blue domed”) cyst

A

Fibrocystic change of the breast

69
Q

Monoclonal antibody spike

A
  • Multiple myeloma (usually IgG or IgA)
  • Monoclonal gammopathy of undetermined significance (MGUS consequence of aging)
  • Waldenström (M protein = IgM) macroglobulinemia
  • Primary amyloidosis
70
Q

Mucin-filled cell with peripheral nucleus

A

“Signet ring” (gastric carcinoma)

71
Q

Narrowing of bowel lumen on barium x-ray

A

“String sign” (Crohn disease)

72
Q 
Necrotizing vasculitis (lungs) 
Necrotizing glomerulonephritis
A

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

73
Q

Needle-shaped, - birefringent crystals

A

Gout (monosodium urate crystals)

74
Q

Nodular hyaline deposits in glomeruli

A

Kimmelstiel-Wilson nodules (diabetic nephropathy)

75
Q

Novobiocin response

A

Sensitive: S epidermidis
Resistant: S saprophyticus

76
Q

“Nutmeg” appearance of liver

A

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

77
Q

“Onion skin” periosteal reaction

A

Ewing sarcoma (malignant small blue cell tumor)

78
Q

Optochin response

A

Sensitive: S pneumoniae
Resistant: viridans streptococci (S mutans, S sanguis)

79
Q

Podocyte fusion or “effacement” on electron microscopy

A

Minimal change disease (child with nephrotic syndrome)

80
Q

Polished, “ivory-like” appearance of bone at cartilage erosion

A

Eburnation (osteoarthritis resulting in bony sclerosis)

81
Q

Protein aggregates in neurons from hyperphosphorylation of tau protein

A

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

82
Q

Psammoma bodies

A

Meningiomas
Papillary thyroid carcinoma
Mesothelioma
Papillary serous carcinoma of the endometrium and ovary

83
Q

Pseudopalisading tumor cells on brain biopsy

A

Glioblastoma multiforme

84
Q

Raised periosteum (creating a “Codman triangle”)

A

Aggressive bone lesion (eg osteosarcoma, Ewing sarcoma, osteomyelitis)

85
Q

RBC casts in urine

A

Glomerulonephritis

86
Q

Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells

A

Reinke crystals (Leydig cell tumor)

87
Q

Recurrent infections
Eczema
Thrombocytopenia

A

Wiskott-Aldrich syndrome

88
Q

Renal epithelial casts in urine

A

Intrinsic renal failure (eg ischemia or toxic injury)

89
Q

Rhomboid crystals, + birefringent

A

Pseudogout (calcium pyrophosphate dihydrate crystals)

90
Q

Rib notching (inferior surface, on x-ray)

A

Coarctation of aorta

91
Q

Ring-enhancing brain lesion on CT/MRI in AIDS

A

Toxoplasma gondii

CNS lymphoma

92
Q

Sheets of medium-sized lymphoid cells with scattered pale, tingible body-laden macrophages (“starry sky” histology)

A

Burkitt lymphoma (t[8:14] c-myc activation, associated with EBV; “starry sky” made up of malignant cells)

93
Q

Silver-staining spherical aggregation of tau proteins in neurons

A

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

94
Q

“Soap bubble” in femur or tibia on x-ray

A

Giant cell tumor of bone (generally benign)

95
Q

“Spikes” on basement membrane

“Dome-like” subepithelial deposits

A

Membranous nephropathy (nephrotic syndrome)

96
Q

Stacks of RBCs

A

Rouleaux formation (high ESR, multiple myeloma)

97
Q

“Steeple” sign on frontal CXR

A

Croup (parainfluenza virus)

98
Q

Stippled vaginal epithelial cells

A

“Clue cells” (Gardnerella vaginalis)

99
Q

Streptococcus bovis bacteremia

A

Colon cancer

100
Q

“Tennis racket” -shaped cytoplasmic organelles (EM) in Langerhans cells

A

Birbeck granules (Langerhans cell histiocytosis)

101
Q

Thousands of polyps on colonoscopy

A

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

102
Q

Thrombi made of white/red layers

A

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

103
Q

“Thumb sign” on lateral neck x-ray

A

Epiglottitis (Haemophilus influenzae)

104
Q

Thyroid-like appearance of kidney

A

Chronic pyelonephritis (usually due to recurrent infections)

105
Q

“Tram-track” appearance of capillary loops of glomerular basement membranes on light microscopy

A

Membranoproliferative glomerulonephritis

106
Q

Triglyceride accumulation in liver cell vacuoles

A

Fatty liver disease (alcoholic or metabolic syndrome)

107
Q

Increased uric acid levels

A

Gout
Lesch-Nyhan syndrome
Tumor lysis syndrome
Loop and thiazide diuretics

108
Q

“Waxy” casts with very low urine flow

A

Chronic end-stage renal disease

109
Q

WBC casts in urine

A

Acute pyelonephritis

110
Q

WBCs that look “smudged”

A

CLL (almost always B cell)

111
Q

“Wire loop” glomerular capillary appearance on light microscopy

A

Diffuse proliferative glomerulonephritis (usually seen with lupus)

112
Q

Yellowish CSF

A

Xanthochromia (eg due to subarachnoid hemorrhages)

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