Classic Labs/Findings Flashcards
inc AFP in amniotic fluid/maternal serum
dating error, anencephaly, spina bifida (neural tube defects)
Anti-centromere antibodies
Scleroderma (CREST)
Anti-desmoglein (anti-desmosome) antibodies
Pemphigus vulgaris (blistering)
Anti-glomerular basement membrane antibodies
Goodpasture syndrome (glomerulonephritis and hemoptysis)
Antihistone antibodies
Drug-induced lupus (eg hydralazine, isoniazid, phenytoin, procainamide)
Anti-IgG Antibodies
Rheumatoid arthritis (systemic inflammation, joint pannus, boutonniere defromity)
Antimitochondrial antibodies (AMAs)
Primary Biliary Cirrhosis (female, cholestasis, portal hypertension)
Antineutrophil cytoplasmic antibodies (ANCAs)
Microscopic polyangiitis and eosinophilic granulomatosis with polyangiits (Churg-Strauss sydnrome) (MPO-ANCA/p-ANCA); granulomatosis with polyangiitis (Wegener; PR3-ANCA/c-ANCA)
Antinuclear antibodies (ANAs: Anti-Smith and anti-dsDNA)
SLE (type III hypersensitivity)
Antiplatelet antibodies
Idiopathic thrombocytopenic purpura
Anti-topoisomerase antibodies
Diffuse systemic scleroderma
Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies
Celiac disease (diarrhea, weight loss)
“Apple core” lesion on barium enema x-ray
colorectal cancer (usually left-sided)
Atypical lymphocytes
EBV
Azurophilic peroxidase positive granular inclusions in granulocytes and myeloblasts
Auer rods (AML, especially the promyelocytic [M3] type)
Bacitracin response
Sensitivie: S pyogenes (group A); resistant: S agalactiae (group B)
“Bamboo spine” on x-ray
Ankylosing spondylitis (Chronic inflammatory arthritis; HLA-B27)
Basophilic nuclear remnants in RBCs
Howell-Jolly Bodies (due to splenectomy or nonfunctional spleen)
Basophilic stippling of RBCs
lead poisoning or sideroblastic anemia
bloody or yellow tap on lumbar puncture
subarachnoid hemorrhage
“boot shaped” heart on x-ray
Tetralogy of Fallot (due to RVH)
branching gram positive rods with sulfur granules
Actinomyces israelii
Bronchogenic apical lung tumor on imaging
Pancoast tumor (can compress cervical sympathetic chain and cause Horner syndrome)
“Brown” tumor of bone
Hyperparathyroidism or osteitis fibrosa cystica (deposited hemosiderin from hemorrhage gives brown color)
Cardiomegaly with apical atrophy
Chagas disease (Trypanosoma cruzi)
Cellular cresents in Bowman capsule
Rapidly progressive crescentic glomerularnephritis
“chocolate cyst” of ovary
endometriosis (frequently involves both ovaries)
Circular grouping of dark tumor cells surrounding pale neurofibrils
Homer-Wright Rosettes (neuroblastoma, medulloblastoma)
Colonies of mucoid Pseudomonas in lungs
Cystic fibrosis (autosomal recessive mutation in CFTR gene —> fat soluble vitamin deficiency and mucous plugs)
dec AFP in amniotic fluid/maternal serum
Down syndrome or other chromosomal abnormalities
Degeneration of dorsal column fibers
Tabes dorsalis (tertiary syphilis), subacute combined degeneration (dorsal columns, lateral corticospinal, spinocerebellar tracts affected)
“Delta wave” on EKG, short PR interval, supraventricular tachycardia
Wolff-Parkinson-White Syndrome (bundle of Kent bypasses AV node)
Depigmentation of neurons in substantia nigra
Parkinson disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia)
Desquamated epithelium casts in sputum
Curschmann spirals (bronchial asthma; can result in whorled mucous plugs)
Disarrayed granulosa cells arranged around collections of eosinophilic fluid
Call-Exner bodies (granulosa cell tumor of the ovary)
Dysplastic squamous cervical cells with “raisinoid” nuclei and hyperchromasia
Koilocytes (HPV: predisposes to cervical cancer)
Electrical alterans (alternating amplitude on EKG)
Pericardial Tamponade
Enlarged cells with intranuclear inclusion bodies
“Owl eye” appearance of CMV
Enlarged thyroid cells with ground-glass nuclei with central clearing
“Orphan Annie” eyes nuclei (papillary carcinoma of the thyroid)
Eosinophilic cytoplasmic inclusions in liver cells
Mallory body (alcoholic liver disease)
Eosinophilic cytoplasmic inclusions in neuron
Lewy body (Parkinson disease and Lewy Body Dementia)
Eosinophilic globule in liver
Councilman body (viral hepatitis, yellow fever), represents hepatocyte undergoing apoptosis
Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar neurons
Negri bodies of rabies
Extracellular amyloid deposition in gray matter of brain
Senile plaques (Alzheimer disease)
Giant B Cells with bilobed nuclei with prominent inclusions (“owl’s eye”)
Reed-Sternberg cells (Hodgkin Lymphoma)
Glomerulus-like structure surrounding vessel in germ cells
Schiller-Duval bodies (yolk sac tumor)
“Hair on end” (“Crew-cut”) appearance on x-ray
Beta-thalassemia, sickle cell disease (marrow expansion)
hCG elevated
Choriocarcinoma, hydatiform mole (occurs with and without embryo, multiple pregnancy)
Heart nodules (granulomatous)
Aschoff bodies (rheumatic fever)
Heterophile antibodies
infectious mononucleosis (EBV)
Hexagonal, double-pointed, needle-like crystals in bronchial secretions
Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)
High level of D-dimers
DVT, PE, DIC
Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Ghon complex (primary TB: Mycobacterium bacilli)
“Honeycomb lung” on X-ray or CT
Interstitial pulmonary fibrosis
Hypercoagulability (leading to migrating DVTs and vasculitis)
Trousseau syndrome (adenocarcinoma of pancreas or lung)
Hypersegemented neutrophils
Megaloblastic anemia (B12 deficiency: neurologic symptoms; folate deficiency: no neurologic symptoms)
Hypertension, hypokalemia, metabolic alkalosis
primary hyperaldosteronism (Conn syndrome)
Hypochromic, microcytic anemia
Iron deficiency anemia, lead poisoning, thalassemia (fetal hemoglobin sometimes present)
Intranuclear eosinophilic droplet-like bodies
Cowdry type A bodies (HSV or VZV)
Iron-containing nodules in alveolar septum
Ferruginous bodies (Asbestosis: inc chance of mesothelioma)
Keratin pearls on a skin biopsy
squamous cell carcinoma
Large granules in phagocytes, immunodeficiency
Chediak-Higashi disease (Congenital failure of phagolysosome formation)
“lead pipe” appearance of colon on abdominal imaging
ulcerative colitis (loss of haustra)
Linear appearance of colon on abdominal imaging
Goodpasture syndrome
Low serum ceruloplasmin
Wilson disease (hepatolenticular degeneration)
“Lumpy bumpy” appearance of glomeruli on immunofluorescence
Poststreptococcal glomerulonephritis (due to deposition of IgG, IgM, and C3)
Lytic (“punched-out”) bone lesions on XR
Multiple Myeloma
Mammary gland (“blue domed”) cyst
Fibrocystic change of the breast
Monoclonal antibody spike
Multiple myeloma (usually IgG or IgA) MGUS Waldenstrom (M protein = IgM) macroglobulinemia Primary amyloidosis
Mucin-filled cell with peripheral nucleus
“Signet ring” (Gastric carcinoma)
Narrowing of hte bowel lumen on barium XR
“String sign” (Crohn disease)
Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis
Granulomatosis with Polyangiitis (Wegner; PR3-ANCA, c-ANCA) and Goodpasture syndrome (anti-GBM antibody)
Needle-shaped, negative birefringent crystals
Gout (monosodium urate crystals)
Nodular hyaline deposits in glomeruli
Kimmelstiel-Wilson nodules (diabetic nephropathy)
Novobiocin response
Sensitive: S epidermidis; resistant: S saprophyticus
“Nutmeg” appearance of liver
Chronic passive congestion of liver due to right heart failure or Budd-Chiari syndrome
“Onion skin” periosteal reaction
Ewing sarcoma (malignant small blue cell tumor)
Optochin response
Sensitive: S penumoniae; resistant: viridans streptococci (S mutans, S sanguis)
Podocyte fusion or “effacement” on EM
minimal change disease (child with nephrotic syndrome)
Polished, “ivory-like” appearance of bone at cartilage erosion
Eburnation (osteoarthritis resulting in bony sclerosis)
Protein aggregates in neurons from hyperphosphorylation of tau protein
Neurofibrillary tangles (Alzheimer disease) and Pick bodies (Pick disease)
Psammoma bodies
Meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of the endometrium and ovary
Pseudopalisading tumor cells on brain biopsy
Glioblastoma multiforme
Raised periosteum (creating “Codman triangle”)
Aggressive bone lesion (eg, oestosarcoma, Ewing sarcoma, osteomyelitis)
RBC casts in urine
Glomerulonephritis
Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells
Reinke crystals (Leydig cell tumor)
Recurrent infections, eczema, thrombocytopenia
Wiskott-Aldrich syndrome
Renal epithelial casts in urine
intrinsic renal failure (ischemia or toxic injury)
Rhomboid crystals, positive birefringent
Pseudogout (calcium pyrophosphate dihydrate crystals)
Rib notching (inferior surface, on XR)
Coarctation of the aorta
Ring-enhancing brain lesion on CT/MRI in AIDS
Toxoplasma gondii, CNS lymphoma
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)
Silver-staining spherical aggregation of tau proteins in neurons
Pick bodies (Pick disease: progressive dementia, changes in personality)
“Soap bubble” in femur or tibia on XR
Giant cell tumor of bone (generally benign)
“Spikes” on basement membrane, “dome-like” subepithelial deposits
Membranous nephropathy (nephrotic syndrome)
Stacks of RBCs
Rouleaux formation (high ESR, multiple myeloma)
“Steeple” sign on frontal CXR
Croup (parainfluenza virus)
Stippled vaginal epithelial cells
“Clue cells” (Gardnerella vaginalis)
Strep bovis bactermia
colon cancer
“Tennis racket” shaped cytoplasmic organelles (EM) in Langerhans cells
Birbeck granules (Langerhans cell histiocytosis)
Thousands of polyps on colonoscopy
familial adenomatous polyposis (Autosomal dominant, mutation of APC gene)
Thrombi made of white/red layers
Lines of Zahn (arterial thrombus, layers of platelets/RBCs)
“Thumb sign” on lateral neck XR
Epligottitis (H flue)
Thyroid like appearance on kidney
Chronic pyelonephritis (usually due to recurrent infections)
“Tram track” appearance of capillary loops of glomerular BM on light microscopy
membranoproliferative glomerulonephritis
Triglyceride accumulation in liver cell vacuoles
Fatty liver disease (alcoholic or metabolic syndrome)
inc uric acid levels
gout, Lesch-Nyan syndrome, tumor lysis syndrome, loop and thiazide diuretics
“waxy” casts with very low urine flow
chronic end-stage renal disease
WBC casts in urine
Acute pyelonephritis
WBCs that look “smudged”
CLL (almost always B cell)
“Wire loop” glomerular capillary appearance on light microscopy
Diffuse proliferative glomerulonephritis (usually seen with lupus)
Yellowish CSF
Xanthochromia (d/t subarachnoid hemorrhage)