Classic Labs/Findings Flashcards
anti-centromere Ab
scleroderma (CREST)
anti-desmoglein (epithelial) Ab
pemphigus vulgaris (blistering)
anti-GBM Ab
Goodpasture syndrome (glomerulonephritis and hemoptysis)
anti-histone Ab
drug-induced SLE (Hydralazine, Isoniazid, Phenytoin, Procainamide)
anti-IgG Ab
RA (systemic inflammation, joint pannus, boutonnière deformity)
anti-mitochondrial Ab (AMAs)
primary biliary cirrhosis (female, cholestasis, portal HTN)
anti-neutrophil cytoplasmic Ab (ANCAs)
- microscopic polyangitis -and- eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome) (MPO-ANCA/p-ANCA)
- granulomatosis with polyangiitis (Wegener, PR3-ANCA/c-ANCA)
anti-nuclear Ab (ANA: anti-Smith and anti-dsDNA)
SLE (type 3 HSR)
anti-platelet Ab
idiopathic thrombocytopenic purpura (ITP)
anti-topoisomerase Ab
diffuse systemic scleroderma
anti-trans.glutamin.ase/anti-gliadin/anti-endomysial Ab
Celiac dz (diarrhea, weight loss)
“apple core” lesion on barium enema x-ray
CRC (L-sided)
atypical lymphocytes
EBV
azurophilic peroxidase (+) granular inclusions in granulocytes and myeloblasts
Auer rods (AML, especially the promyelocytic [M3] type)
Bacitracin response
sensitive: S. pyogenes group A
resistant: S. agalactiae group B
“bamboo spine” on xray
ankylosing spondylitis (chronic inflammatory arthritis; HLA-B27)
basophilic nuclear remnants in RBCs
Howell-Jolly bodies (d/t splenectomy or nonfunctional spleen)
basophilic stippling of RBCs
lead poisoning or sideroblastic anemia
bloody or yellow tap on lumber puncture
SAH
“boot-shaped” heart on x-ray
Tetralogy of Fallot (d/t 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
HYPER-parathyroidism or osteitis fibrosa cystica (deposited hemosiderin from hemorrhage gives brown color)
cardiomegaly with apical atrophy
Chagas disease (Trypanosoma cruzi)
cellular crescents in Bowman capsule
rapidly progressive crescentic glomerulonephritis (RPGN)
“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
CF (AR mutation in CFTR gene–>fat soluble vitamin deficiency and mucous plugs)
DEC AFP in amniotic fluid/maternal serum
DS or other chromosomal abnormalities
degeneration of dorsal column pathways
tabes dorsalis (tertiary syphilis), subacute combined degeneration (dorsal columns, lateral corticospinal, spinocerebellar tracts affected)
“delta wave” on EKG, short PR interval, SVT
WPW syndrome (bundle of Kent bypasses AV nodes)
depigmentation of neurons in SN
Parkinson dz (basal ganglia d/o; rigidity, resting tremor, bradykinesia)
desquamated epithelium casts in sputum
Curschmann spirals (bronchial asthma; can result in whorled mucus plugs)
Call-Exner bodies (granulosa cell tumor of the ovary)
Call-Exner bodies (granulosa cell tumor of the ovary)
dysplastic squamous cervical cells with “raisinoud” nuclei and hyperchromasia
koilocytes (HPV: predisposes to cervical ca)
electrical alternans (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 inclusion in liver cell
Mallory body (alcoholic liver dz)
eosinophilic cytoplasmic inclusion in nerve cell
Lewy body (Parkinson disease)
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 xray
beta-thalassemia, SCD (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, dbl-pointed, needle-like crystals in bronchial secretions
bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)
high levels 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 xray or CT
interstitial pulmonary fibrosis
hypercoagulability (leading to migrating DVTs and vasculitis)
Trousseau syndrome (adenocarcinoma of pancreas or lung)
hypersegmented neutrophils
megaloblastic anemia
- B12 deficiency: neurologic symptoms
- folate deficiency: no neurologic symptoms
HTN, hypo-kalemia, metabolic alkalosis
Conn syndrome (primary HYPER-aldosteronism)
hypochromic, microcytic anemia
- iron deficiency anemia
- lead poisoning
- thalassemia (fetal Hgb sometimes present)
INC AFP in amniotic fluid/maternal serum
- dating error
- anencephaly
- spina bifida (NTD)
INC uric acid levels
- gout
- Lesch-Nyhan syndrome
- tumor lysis syndrome
- loop and thiazide diuretics
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 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 IgG deposition on glomerular and alveolar basement membranes
Goodpasture syndrome
low serum ceruloplasmin
Wilson dz (hepatolenticular degeneration)
lumpy bumpy appearance of glomeruli on immunofluorescence
PSGN (d/t deposition of IgG, IgM, and C3)
lytic punched out bone lesions on xray
multiple myeloma
mammary gland blue domes cyst
fibrocystic change of the breast
monoclonal Ab spike
- multiple myeloma (usually IgG or IgA)
- monoclonal gammopathy of undetermined significance (MGUS consequence of aging)
- Waldenstrom (M protein=IgM) macroglobulinemia
- primary amyloidosis
mucin-filled cell with peripheral nucleus
signet ring (gastric carcinoma)
narrowing of bowel lumen on barium xray
string sign (Crohn disease)
necrotizing vasculitis (lungs) and necrotizing glomerulonephritis
granulomatosis with polyangiitis (Wegener; PR3-ANCA/c-ANCA) and Goodpasture syndrome (anti-basement membrane Ab)
needle-shaped, negatively 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 d/t R. HF or Budd-Chiari syndrome
onion skin periosteal reaction
Ewing sarcoma (malignant small blue cell tumor)
optochin response
- sensitive: S. pneumo
- resistant: viridans streptococci (S. mutans, S. sanguis)
periosteum raised from bone, creating triangular area
Codman triangle on xray, Ewing sarcoma, pyogenic osteomyelitis
podocyte fusion or effacement on EM
Minimal change dz (kid with nephrotic syndrome)
polished ivory-like appearance of bone at cartilage erosion
eburnation (osteoarthiritis resulting in bony sclerosis)
protein aggregates in neurons from hyperphosphorylation of tau protein
neurofibrillary tangles (Alzheimer disease) and Pick bodies (Pick dz)
