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Classic Labs/Findings Flashcards

1
Q

Classic Labs/Findings

↑ AFP in amniotic fluid/maternal serum

A

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

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2
Q

Classic Labs/Findings

Anticentromere antibodies

A

Scleroderma (CREST)

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3
Q

Classic Labs/Findings

Anti-desmoglein (anti-desmosome) antibodies

A

Pemphigus vulgaris (blistering)

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4
Q

Classic Labs/Findings

Anti-glomerular basement membrane antibodies

A

Goodpasture syndrome (glomerulonephritis and hemoptysis)

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5
Q

Classic Labs/Findings

Antihistone antibodies

A

Drug-induced SLE (eg hydralazine, isoniazid, phenytoin, procainamide)

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6
Q

Classic Labs/Findings

Anti-IgG antibodies

A

Rheumatoid arthritis (systemic inflammation, jint pannus, boutonniere deformity)

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7
Q

Classic Labs/Findings

Antimitochondrial antibodies (AMAs)

A

1° biliary cirrhosis (female, cholestasis, portal hypertension)

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8
Q

Classic Labs/Findings

Antineutrophil cytoplasmic antibodies (ANCAs)

A

Microscopic polyangitis 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

Classic Labs/Findings

Antinuclear antibodies (ANAs: anti-Smith & anti-dsDNA)

A

SLE (type III hypersensitivity)

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10
Q

Classic Labs/Findings

Antiplatelet antibodies

A

Idiopathic thrombocytopenic purpura

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11
Q

Classic Labs/Findings

Anti-topoisomerase antibodies

A

Diffuse systemic scleroderma

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12
Q

Classic Labs/Findings

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

A

Celiac disease (diarrhea, weight loss)

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13
Q

Classic Labs/Findings

“Apple core” lesion on barium enema x-ray

A

Colorectal cancer (usually left-sided)

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14
Q

Classic Labs/Findings

Atypical lymphocytes

A

EBV

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15
Q

Classic Labs/Findings

Azurophilic peroxidase ⊕ granular inclusions in granulocytes and myeloblasts

A

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

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16
Q

Classic Labs/Findings

Bacitracin response

A

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

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17
Q

Classic Labs/Findings

“Bamboo spine” on X-ray

A

Ankylosing spondylitis (chronic inflammatory arthritis HLA-B27)

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18
Q

Classic Labs/Findings

Basophilic nuclear remnants in RBCs

A

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

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19
Q

Classic Labs/Findings

Basophilic stippling of RBCs

A

Lead poisoning or sideroblastic anemia

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20
Q

Classic Labs/Findings

Bloody or yellow tap on lumbar puncture

A

Subarachnoid hemorrhage

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21
Q

Classic Labs/Findings

“Boot-shaped” heart on X-ray

A

Tetralogy of Fallot (due to RVH)

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22
Q

Classic Labs/Findings

Branching gram ⊕ rods with sulfur granules

A

Actinomyces israelii

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23
Q

Classic Labs/Findings

Bronchogenic apical lung tumor on imagaing

A

Pancoast tumor (can compress sympathetic chain and cause Horner syndrome)

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24
Q

Classic Labs/Findings

“Brown” tumor of bone

A

Hyperparathyroidism or osteitis fibrosa cystica (deposited hemosiderin from hemorrhage gives brown color)

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25
Q

Classic Labs/Findings

Cardiomegaly with apical atrophy

A

Chagas disease (Trypanosoma cruzi)

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26
Q

Classic Labs/Findings

Cellular crescents in Bowman capsule

A

Rapidly progressive crescentic glomerulonephritis

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27
Q

Classic Labs/Findings

“Chocolate cyst” of ovary

A

Endometriosis (frequently involves both ovaries)

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28
Q

Classic Labs/Findings

Circular grouping of dark tumor cells surrounding pale neurofibrils

A

Homer-Wright rosettes (neuroblastoma, medulloblastoma)

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29
Q

Classic Labs/Findings

Colonies of mucoid Pseudomonas in lungs

A

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

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30
Q

Classic Labs/Findings

↓ AFP in amniotic fluid/maternal serum

A

Down syndrome or other chromosomal abnormalities

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31
Q

Classic Labs/Findings

Degeneration of dorsal column fibers

A

Tabes dorsalis (3° syphilis), subacute combined degeneration (dorsal columns, lateral corticospinal, spinocerebellar tracts affected)

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32
Q

Classic Labs/Findings

“Delta wave” on EKG, short PR interval, supraventricular tachycardia

A

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

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33
Q

Classic Labs/Findings

Depigmentation of neurons in substantia nigra

A

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

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34
Q

Classic Labs/Findings

Desquamated epithelium casts in sputum

A

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

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35
Q

Classic Labs/Findings

Disarrayed granulosa cells arranged around collections of eosinophilic fluid

A

Call-Exner bodies (granulosa cell tumor of the ovary)

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36
Q

Classic Labs/Findings

Dysplastic squamous cervical cells with “raisinoid” nuclei and hyperchromasia

A

Koilocytes (HPV: predisposes to cervical cancer)

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37
Q

Classic Labs/Findings

Electrica alternans (alternating amplitude on EKG)

A

Pericardial tamponade

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38
Q

Classic Labs/Findings

Enlarged cells with intranuclear inclusion bodies

A

“Owl eye” appearance of CMV

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39
Q

Classic Labs/Findings

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

Classic Labs/Findings

Eosinophilic cytoplasmic inclusion in liver cell

A

Mallory body (alcoholic liver disease)

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41
Q

Classic Labs/Findings

Eosinophilic cytoplasmic inclusion in neuron

A

Lewy body (Parkinson disease & Lewy body dementia)

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42
Q

Classic Labs/Findings

Eosinophilic globule in liver

A

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

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43
Q

Classic Labs/Findings

Eosinophilic inclusions bodies in cytoplasm of hippocampal and cerebellar neurons

A

Negri bodies of rabies

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44
Q

Classic Labs/Findings

Extracellular amyloid deposition in gray matter of brain

A

Senile plaques (Alzheimer disease)

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45
Q

Classic Labs/Findings

Giant B cels with bilobed nuclei with prominent inclusions (“owl’s eye”)

A

Reed-Sternberg cells (Hodgkin lymphoma)

46
Q

Classic Labs/Findings

Glomerulus-like structure surrounding vessel in germ cells

A

Schiller-Duval bodies (yolk sac tumor)

47
Q

Classic Labs/Findings

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

A

β-thalassemia, sickle cell disease (marrow expansion)

48
Q

Classic Labs/Findings

hCG elevated

A

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

49
Q

Classic Labs/Findings

Heart nodules (granulomatous)

A

Aschoff bodies (rheumatic fever)

50
Q

Classic Labs/Findings

Heterophile antibodies

A

Infectious mononucleosis (EBV)

51
Q

Classic Labs/Findings

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

A

Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)

52
Q

Classic Labs/Findings

High level of D-dimers

A

DVT, PE, DIC

53
Q

Classic Labs/Findings

Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify)

A

Ghon complex (1° TB: Mycobaterium bacilli)

54
Q

Classic Labs/Findings

“Honeycomb lung” on x-ray or CT

A

Interstitial pulmonary fibrosis

55
Q

Classic Labs/Findings

Hypercoagulability (leading to migrating DVTs and vasculitis)

A

Trousseau syndrome (adenocarcinoma of pancreas or lung)

56
Q

Classic Labs/Findings

Hypersegmented neutrophils

A

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

57
Q

Classic Labs/Findings

Hypertension, hypokalemia, metabolic alkalosis

A

1° hyperaldosteronism (Conn syndrome)

58
Q

Classic Labs/Findings

Hypochromic, microcytic anemia

A

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

59
Q

Classic Labs/Findings

Intranuclear eosinophilic droplet-like bodies

A

Cowdry type A bodies (HSV or VZV)

60
Q

Classic Labs/Findings

Iron-containing nodules in alveolar sputum

A

Ferruginous bodies (asbetosis: ↑ chance of mesothelioma)

61
Q

Classic Labs/Findings

Keratin pearls on a skin biopsy

A

Squamous cell carcinoma

62
Q

Classic Labs/Findings

Large granules in phagocytes, immunodeficiency

A

Chediak-Higashi disease (congenital failure of phagolysosome formation)

63
Q

Classic Labs/Findings

“Lead pipe” appearance of colon on abdominal imaging

A

Ulcerative colitis (loss of haustra)

64
Q

Classic Labs/Findings

Linear appearance of IgG deposition on glomerular and alveolar basement membranes

A

Goodpasture syndrome

65
Q

Classic Labs/Findings

Low serum ceruloplasmin

A

Wilson disease (hepatolenticular degeneration

66
Q

Classic Labs/Findings

“Lumpy bumpy” appearance of glomeruli on immunofluorescence

A

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

67
Q

Classic Labs/Findings

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

A

Multiple myeloma

68
Q

Classic Labs/Findings

Mammary gland (“blue-domed”) cyst

A

Fibrocystic change of the breast

69
Q

Classic Labs/Findings

Monoclonal antibody spike

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

Classic Labs/Findings

Mucin-filled cell with peripheral nucleus

A

“Signet ring” (gastric carcinoma)

71
Q

Classic Labs/Findings

Narrowing of bowel lumen on barium x-ray

A

“String sign” (Crohn disease)

72
Q

Classic Labs/Findings

Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis

A

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

73
Q

Classic Labs/Findings

Needle-shaped, ⊖ birefringent crystals

A

Gout (monosodium urate crystals)

74
Q

Classic Labs/Findings

Nodular hyaline deposits in glomeruli

A

Kimmelstiel-Wilson nodules (diabetic nephropathy)

75
Q

Classic Labs/Findings

Novobiocin response

A

Sensitive: S. epidermidis
Resistant: S. saprophyticus

76
Q

Classic Labs/Findings

“Nutmeg” appearance of liver

A

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

77
Q

Classic Labs/Findings

“Onion skin” periosteal reaction

A

Ewing sarcoma (malignant small blue cell tumor)

78
Q

Classic Labs/Findings

Optochin response

A

Sensitive: S. pneumoniae
Resistant: viridans streptococcii (S. mutans, S. sanguis)

79
Q

Classic Labs/Findings

Podocyte fusion or “effacement” on electron microscopy

A

Minimal change disease (child with nephrotic syndrome)

80
Q

Classic Labs/Findings

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

A

Eburnation (osteoarthritis resulting in bony sclerosis)

81
Q

Classic Labs/Findings

Protein aggregates in neurons from hyperphosphorylation of tau protein

A

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

82
Q

Classic Labs/Findings

Psammoma bodies

A

Meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of the endometrium and ovary

83
Q

Classic Labs/Findings

Pseudopalisading tumor cells on brain biopsy

A

Gliobastoma multiforme

84
Q

Classic Labs/Findings

Raised periosteum (creating a “Codman triangle”)

A

Aggressive bone lesion (e.g. osteosarcoma, Ewing sarcoma, osteomyelitis)

85
Q

Classic Labs/Findings

RBC casts in urine

A

Glomerulonephritis

86
Q

Classic Labs/Findings

Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells

A

Reinke crystals (Leydig cell tumor)

87
Q

Classic Labs/Findings

Recurrent infections, eczema, thrombocytopenia

A

Wiskott-Aldrich syndrome

88
Q

Classic Labs/Findings

Renal epithelial casts in urine

A

Intrinsic renal failure (e.g. ischemia or toxic injury)

89
Q

Classic Labs/Findings

Rhomboid crystals, ⊕ birefringent

A

Pseudogout (calcium pyrophosphate dihydrate crystals)

90
Q

Classic Labs/Findings

Rib notching (inferior surface, on x-ray

A

Coarctation of the aorta

91
Q

Classic Labs/Findings

Ring-enhancing brain lesion on CT/MRI in AIDS

A

Toxoplasma gondii, CNS lymphoma

92
Q

Classic Labs/Findings

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

Classic Labs/Findings

Silver-staining spherical aggregation of tau proteins in neurons

A

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

94
Q

Classic Labs/Findings

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

A

Giant cell tumor of bone (generally benign)

95
Q

Classic Labs/Findings

“Spikes” on basement membrane, “dome-like” subepithelial deposits

A

Membranous nephropathy (nephrotic syndrome)

96
Q

Classic Labs/Findings

Stacks of RBCs

A

Rouleaux formation (high ESR, multiple myeloma)

97
Q

Classic Labs/Findings

“Steeple” sign on frontal CXR

A

Croup (parainfluenza virus)

98
Q

Classic Labs/Findings

Stippled vaginal epithelial cells

A

“Clue cells” (Gardnerella vaginalis)

99
Q

Classic Labs/Findings

Streptococcus bovis bacteremia

A

Colon cancer

100
Q

Classic Labs/Findings

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

A

Birbeck granules (Langerhans cell histocytosis)

101
Q

Classic Labs/Findings

Thousands of polyps on colonoscpy

A

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

102
Q

Classic Labs/Findings

Thrombi made of white/red layers

A

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

103
Q

Classic Labs/Findings

“Thumb sign” on lateral neck x-ray

A

Epiglottitis (Haemophilus influenzae)

104
Q

Classic Labs/Findings

Thyroid-like appearance of kidney

A

Chronic pyelonephritis (usually due to recurrent infection)

105
Q

Classic Labs/Findings

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

A

Membranoproliferative glomerulonephritis

106
Q

Classic Labs/Findings

Triglyceride accumulation in liver cell vacuoles

A

Fatty liver disease (alcoholic or metabolic syndrome)

107
Q

Classic Labs/Findings

↑ uric acid levels

A

Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics

108
Q

Classic Labs/Findings

“Waxy” casts with very low urine flow

A

Chronic end-stage renal disease

109
Q

Classic Labs/Findings

WBC casts in urine

A

Acute pyelonephritis

110
Q

Classic Labs/Findings

WBCs that look “smudged”

A

CLL (almost always B cell)

111
Q

Classic Labs/Findings

“Wire loop” glomerular capillary appearance on light microscopy

A

Diffuse proliferative glomerulonephritis (usually seen with lupus)

112
Q

Classic Labs/Findings

Yellowish CSF

A

Xanthochromia (e.g. due to subarachnoid hemorrhage)

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