Classic Labs/ Findings Flashcards
1
Q
Increased AFP in amniotic fluid or in maternal serum?
A
Dating error, anenchephaly, or spina bifida
2
Q
Anticentromere antibodies
A
Scleroderma (CREST)
3
Q
Anti-desmoglein (anti-desmosome) antibodies
A
Pemphigus vulgaris (blistering)
4
Q
Anti-glomerular basement membrane antibodies
A
Goodpasture syndrome (glomerulonephritis and hemoptysis)
5
Q
Antihistone antibodies
A
Drug-induced SLE (eg., hydralazine, isoniazid, phenytoin, procainamide)
6
Q
Anti-IgG antibodies
A
Rheumatoid arthritis (systemic inflamation, joint pannus, boutonniere deformity)
7
Q
Antimitochondrial antibodies
A
Primary biliary cirrhosis (female, cholestasis, portal hypertension)
8
Q
Antineutrophil cytoplasmic antibodies
A
Microscopic polyangitis and eosinophilic granulomatosis with polyangitis (MPO-ANCA/ p-ANCA); granulomatosis with polyangitis (Wegener; PR3-ANCA/ c-ANCA); primary sclerosing cholangitis (MPO-ANCA/ p-ANCA)
9
Q
Antinuclear antibodies (anti-Smith and anti-dsDNA)
A
SLE (type III hypersensitivity)
10
Q
Antiplatelet antibodies
A
Idiopathic thrombocytopenic purpura
11
Q
Anti-toposomerase antibodies
A
Diffuse systemic scleroderma
12
Q
Anti-transglutaminase/ anti-gliadin/ anti-endomysial antibodies
A
Celiac disease (diarrhea, weight loss)
13
Q
“Apple core” lesion on barium enema x-ray
A
Colorectal cancer (usually L sided)
14
Q
Atypical lymphocytes
A
EBV
15
Q
Azurophilic peroxidase + granular inclusions in granulocytes and myeloblasts
A
Auer rods (AML)
16
Q
Bacitracin response
A
Sensitive: Group A Strep, Resistant: Group B Strep
17
Q
“Baboo spine” on x-ray
A
Ankylosing spondylitis (chronic inflammatory arthritis; HLA-B27)
18
Q
Basophilic nuclear remnants in RBCs
A
Howell-Jolly bodies (due to splenectomy or non-functional spleen)
19
Q
Basophilic stippling of RBCs
A
Lead poisoning or sideroblastic anemic
20
Q
Bloody or yellow tap on lumbar puncture
A
Subarachnoid hemorrhage
21
Q
“Boot-shaped heart” on x-ray
A
Tetralogy of Fallot (due to RVH)
22
Q
Branching G+ rods with sulfur granules
A
Actinomyces israelii
23
Q
Bronchogenic apical lung tumor on imaging
A
Pancoast tumor (can compress cervical sympathetic chain and cause Horner syndrome)
24
Q
“Brown” tumor of bone
A
Hyperparathyroidism or osteitis fibrosa cystica (deposited hemosiderin from hemorrhage gives brown color)
25
Cardiomegaly with apical atrophy
Chagas disease (Trypanosoma cruzi)
26
Cellular crescents in Bowman capsule
Rapidly progressive cresenteric glomerulonephritis
27
"Chocolate cyst" of ovary
Endometriosis (frequently involves both ovaries)
28
Circular group of dark tumor cells surroundin pale neurofibrils
Homer-Wright rosettes (neuroblastoma, medulloblastoma)
29
Colonies of mucoid Pseudomonas in lungs
Cystic fibrosis (autosomal recessive mutation in CFTR gene)
30
Decreased AFP in amniotic fluid/ maternal serum
Down syndrome or other chromosomal abnormalities
31
Degeneration of dorsal column fibers
Tabes dorsalis (tertiary syphilis), subacute combined degeneration (dorsal columns, lateral corticospinal, spinocerebellar tracts affected)
32
"Delta wave" on EKG, short PR interval, supraventricular tachycardia
Wolff-Parkinson-White syndrome (Bundle of Kent bypasses AV node)
33
Desquamated epithelium casts in sputum
Curschmann spirals (bronchial asthma; can result in whorled mucus plugs)
34
Disarrayed granulosa cells arranged around collections of eosinophilic fluid
Call-Exner bodies (granulosa cell tumor of the ovary)
35
Dysplastic squamous cervical cells with "raisinoid" nuclei and hyperchromasia
Koilocytes (HPV)
36
Electrical alternans (alternating amplitude on EKG)
Pericardial tamponade
37
Enlarged cells with intranuclear inclusion bodies
"Owl-eye" appearance of CMV
38
Enlarged thyroid cells with ground glass nuclei with central clearing
Orphan annie eyes nuclei (papillary carcinoma of the thyroid)
39
Eosinophilic cytoplasmic inclusion in liver cell
Mallory body (alcoholic liver disease)
40
Eosinophilic cytoplasmic inclusion within neuron bodies
Lewy body
41
Eosinophilic globule in the liver
Councilman body (viral hepatitis, yellow fever), represents hepatocyte undergoing apoptosis
42
Eosinophilic inclusion bodies in the cytoplasm of hippocampal and cerebellar neurons
Negri bodies of rabies
43
Extracellular amyloid deposition in gray matter of brain
Senile plaques (Alzheimer's)
44
Giant B cells with bilobed nuclei with prominent inclusions (owl's eyes)
Reed-Sternberg cells (Hodgkin lymphoma)
45
Glomerulus-like structure surrounding vessel in germ cells
Schiller-Duval bodies (yolk sac tumor)
46
"Hair on end" ("crew cut") appearance on x-ray
Beta-thalessemia, sickle cell disease (marrow expansion)
47
hCG elevated
Choriocarcinoma, hydatidiform mole (occurs with and without embyro, and multiple pregnancy)
48
Heart nodules (granulomatous)
Aschoff bodies (rheumatic fever)
49
Heterophile antibodies
Infectious mononucleosis (EBV)
50
Hexagonal, double-pointed, needle like crystals in bronchial secretions
Bronchial astham (Charcot-Leyden crystals; eosinophilic granules)
51
High levels of d-dimer
DVT, PE, DIC
52
Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Ghon complex (Primary TB: mycobacterium bacilli
53
"Honeycomb lung" on x-ray or CT
Interstitial pulmonary fibrosis
54
Hypercoaguability (leading to migrating DVT and vasculitis)
Trousseau syndrome (adenocarcinoma of pancreas or lung)
55
Hypersegmented neutrophils
Megaloblastic anemia
56
HTN, hypokalemia, and metabolic alkalosis
Primary hyperaldosteronism (Conn syndrome)
57
Hypochromic, microcytic anemia
Iron deficiency anemia, lead poisoning, thalassemia
58
Intranuclear eosinophilic droplet-like bodies
Cowdry type A bodies (HSV or VZV)
59
Iron-containing nodules in alveolar septum
Ferruginous bodies (asbestosis)
60
Keratin pearls on a skin biopsy
Squamous cell carcinoma
61
Large granules in phagocytes, immunodeficiency
Chediak-Higashi disease (congenital failure of phagolysosome formation)
62
"Lead pipe" appearance of colon on abdominal imaging
Ulcerative colitis (loss of haustra)
63
Linear appearance of IgG deposition on glomerular and alveolar basement membranes
Goodpasture syndrome
64
Low serum ceruloplasmin
Wilson disease (hepatolenticular degeneration)
65
"Lumpy bumpy" appearance of glomeruli on immunofluorescence
Poststreptococcal glomerulonephritis (deposition of IgG, IgM, and C3)
66
Lytic "punched out" bone lesions
Multiple myeloma
67
Mammary gland "blue-domed" cyst
Fibrocystic change of the breast
68
Monoclonal antibody spike
Multiple myeloma (usually IgG or IgA); Monoclonal gammopathy of undetermined significance (MGUS consequence of aging); Waldenstrom (M protein= IgM) macroglobulinemia; primary amyloidosis
69
Mucin-filled cell with peripheral nucleus
"Signet ring" (gastric carcinoma)
70
Narrowing of bowel lumen on barium x-ray
"String sign" Crohn disease
71
Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis
Granulomatosis with polyangitis (Wegener; PR3-ANCA/c-ANCA) and Goodpasture syndrome (anti-basement membrane antibodies)
72
Needle-shaped, negatively birefringent crystals
Gout (monosodium urate crystals)
73
Nodular hyaline deposits in glomeruli
Kimmelstiel-Wilson nodules (diabetic nephropathy)
74
Novobiocin response
Sensitive: S. epidermidis; resistant: S. saprophyticus
75
"Nutmeg appearance" of liver
Chronic passve congestion of liver due to right heart failure or Budd-Chiari syndrome
76
"Onion skin" periosteal reaction
Ewing sarcoma (malignant small blue cell tumor)
77
Optochin sensitivity
Sensitive: S. pneumoniae; Resistant: Viridins strep
78
Podocyte fusion or effacement on EM
Minimal change disease
79
Protein aggregates in neurons from hyperphosphorylation of tau protein
Neurofibrillary tangles (Alzheimer disease) and Pick bodies (Pick disease)
80
Psammoma bodies
Meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of endometrium and ovary
81
Pseudopalisading tumor cells on brain biopsy
Glioblastoma multiforme
82
Raised periosteum (creating Codman's triangle)
Aggressive bone lesion (eg, osteosarcoma, Ewing sarcoma, osteomyelitis)
83
RBC casts in urine
Glomerulonephritis
84
Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells
Reinke crystals (Leydig cell tumor)
85
Recurrent infections, eczema, thrombocytopenia
Wiskott-Aldrich syndrome
86
Renal epithelial casts in urine
Intrinsic renal failure
87
Rhomboid crystals, positively birefringent
Pseudogout (calcium pyrophosphate dihydrate crystals)
88
Rib notching (inferior surface, on x-ray)
Coarctation of the aorta
89
Ring-enhancing brain lesions on CT/MRI in AIDS
Toxoplasma gondii, CNS lymphoma
90
Sheets of medium-sized lymphoid cells with scattered pale, tingible body-laden macrophages
"Starry sky" histology- Burkitt lymphoma (t[8;14] c-myc activation, assc. with EBV)
91
Silver-staining spherical aggregation of tau protein in neurons
Pick bodies (Pick disease: progressive dementia, changes in personality)
92
"Soap bubble" in femur or tibia on x-ray
Giant cell tumor of bone (generally benign)
93
"Spikes" on basement membrane, "dome-like" subepithelial deposits
Membranous nephropathy (nephrotic syndrome)
94
Stacks of RBCs
Rouleaux formation (high ESR, multiple myeloma)
95
"Steeple" sign on frontal CXR
Croup (parainfluenza virus)
96
Bacteria-covered vaginal epithelial cells
"Clue cells" (Gardenella vaginalis)
97
Strep bovis bacteremia
Colon cancer
98
"Tennis-racket"-shaped cytoplasmic organelles in Langerhans cells on EM
Birbeck granules (Langerhans cell histiocytosis)
99
Thousands of polyps on colonoscopy
Familial adenomatous polyposis (auto dom mutation of APC gene)
100
Thrombi made of white/red layers
Lines of Zahn (arterial thrombus, layers of platelets/RBCs)
101
"Thumb sign" on lateral neck x-ray
Epiglottitis (H. influenzae)
102
Thyroid like appearance of kidney
Chronic pyelonephritis
103
"tram-track appearance of capillary loops of glomerular basement membranes on light microscopy
Membranoproliferative glomerulonephritis
104
Triglyceride accumulation in liver cell vacuoles
Fatty liver disease (alcoholic or metabolic syndrome)
105
Increased uric acid levels
Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics
106
"Waxy" casts with very low urine flow
End-stage renal disease
107
WBC cases in urine
Acute pyelonephritis
108
WBCs that look "smudged"
CLL (almost always B cell)
109
"Wire loop" glomerular capillary appearance on light microscopy
Diffuse proliferative glomerulonephritis (usually seen with lupus)
110
Yellowish CSF
Xanthochromia
