Classic Labs/Findings Flashcards
1
Q
Anticentromere antibodies
A
Scleroderma (CREST)
2
Q
Anti-desmoglein (epithelial) antibodies
A
Pemphigus vulgaris (blistering)
3
Q
Anti-glomerular basement membrane antibodies
A
Goodpasture syndrome (glomerulonephritis and hemoptysis)
4
Q
Antihistone antibodies
A
Drug-induced SLE (e.g., hydralazine, isoniazid, phenytoin, procainamide)
5
Q
Anti-IgG antibodies
A
Rheumatoid arthritis (systemic inflammation, joint pannus, boutonnière deformity)
6
Q
Antimitochondrial antibodies (AMAs)
A
Primary biliary cirrhosis (female, cholestasis, portal hypertension)
7
Q
Antineutrophil cytoplasmic antibodies (ANCAs)
A
Microscopic polyangitis and eosinophilia granulomatosis with polyangitis (Churg-Strauss syndrome) (MPO-ANCA/p-ANCA);
Granulomatosis with polyangitis (Wegener; PR3-ANCA/c-ANCA)
8
Q
Antinuclear antibodies (ANAs:anti-Smith and anti-dsDNA
A
SLE (type 3 hypersensitivity)
9
Q
Anti-platelet antibodies
A
Idiopathic thrombocytopenic purpura
10
Q
Anti-topoisomerase
A
Diffuse systemic scleroderma
11
Q
Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies
A
Celiac Disease (diarrhea, weight loss)
12
Q
“Apple core” lesionon barium enema x-ray
A
Colorectal cancer (usually left-sided)
13
Q
Atypical lymphocytes
A
EBV
14
Q
Azurophilic peroxidase positive granular inclusions in granulocytes and myeloblasts
A
Auer rods (AML, especially the promyelocytic (M3) type)
15
Q
Bacitracin response
A
Sensitive: Streptococcus pyogenes (group A)
Resistant: Streptococcus agalactiae (group B)
16
Q
“Bamboo spine” on X-ray
A
Ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27)
17
Q
Basophilic nuclear remnants in RBCs
A
Howell-Jolly bodies (due to splenectomy or nonfunctional spleen)
18
Q
Basophilic stippling of RBCs
A
Lead poisoning or sideroblastic anemia
19
Q
Bloody or yellow tap on lumbar puncture
A
Subarachnoid hemorrhage
20
Q
“Boot shaped” heart on x-ray
A
Tetralogy of Fallot (due to RVH)
21
Q
Branching gram positive rods with sulfur granules
A
Actinomyces Israeli
22
Q
Brochogenic apical lung tumor on imaging
A
Pancoast tumor (can compress cervical sympathetic chain and cause Horner syndrome)
23
Q
“Brown” tumor of bone
A
Hyperparathyroidism or osteitis fibrosis cystica (deposited hemosiderin from hemorrhage gives brown color)
24
Q
Cardiomegaly with apical atrophy
A
Chagas’ disease (trypanosoma Cruzi)
25
Cellular crescents in bowman capsule
Rapidly progressive cresenteric glomerulonephritis
26
'Chocolate cyst' of ovary
Endometriosis (frequently involves both ovaries)
27
Circular Grouping of dark tumor cells surrounding pale neurofibrils
Homer-Wright rosettes (neuroblastoma, medulloblastoma)
28
Colonies of mucous Pseudomonas in lungs
Cystic fibrosis (AR mutation in CFTR gene----> fat soluble vitamin deficiency and mucous plugs)
29
Decrease AFP in amniotic fluid/maternal serum
Down syndrome or other chromosomal abnormalities
30
Degeneration of dorsal column fibers
Tabes Dorsalis (tertiary syphilis)
Subacute combined degeneration of the spinal cord
(dorsal columns, lateral corticospinal, spinocerebellar tracts affected)
31
"Delta wave" on EKG, short PR interval, supraventricular tachycardia
Wolf-Parkinson-White syndrome (Bundle of Kent bypasses AV node)
32
Depigmentation of neurons in substantia nigra
Parkinson Disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia)
33
Desquamated epithelium casts in sputum
Curschmann spirals (bronchial asthma; can result in whorled mucous plugs)
34
Disarrayed granulosa cells arranged around collections of eosinophilia fluid
Call-Exner bodies (granulosa cell tumor of the ovary)
35
Dysplastic squamous cervical cells with "rasinoid" nuclei and hyperchromasia
Koilocytes (HPV: predisposes to cervical cancer)
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 in nerve cell
Lewy body (Parkinson Disease)
41
Eosinophilic globule in liver
Councilman body (viral hepatitis, yellow fever), represents hepatocyte undergoing apoptosis
42
Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellum neurons
Negri bodies of rabies
43
Extracellular amyloid deposition in gray matter of brain
Senile plaques (Alzheimer's disease)
44
Giant B cells with bilobed nuclei with prominent inclusions ("owls's eye")
Reed-Sternberg cells (Hodgkin lymphoma)
45
Glomerulus-like structure surround vessel in germ cells
Schiller-Duval bodies (yolk sac tumor)
46
"Hair on end" ("crew cut") appearance on X-ray
B-thalassemia, sickle cell Disease (marrow expansion)
47
hCG elevate
Choriocarcionoma, hydatidiform mole (occurs with and without embryo, and multiple pregnancy).
48
Heart nodules (granulomatous)
Aschoff bodies (Rhuematic fever)
49
Heterophile antibodies
Infectious mononucleosis (EBV)
50
Hexagonal, double-pointed, needle like crystals in bronchial secretions
Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)
51
High level of D-dimers
DVT, PE,DIC
52
Hilar lymphadenopathy, peripheral granulomatosis 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
Hypercoagulability (leading to migrating DVTs and vasculitis)
Trousseau syndrome (adenocarcinoma of pancreas or lung)
55
Hypersegmented neutrophils
Megaloblastic anemia (B12 deficiency: neurological symptoms; folate deficiency:no neurological symptoms)
56
Hypertension, hypokalemia, metabolic alkalosis
Conn syndrome (primary hyperaldosteronism)
57
Hypochromic, microcytic anemia
Thalassemia (fetal hemoglobin sometimes present)
A
Iron deficiency anemia
Lead poisoning
58
Increased AFPmin amniotic fluid or maternal serum
Dating error, anencephaly, spina bifida (NTDs)
59
Increased Uris acid levels
Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics
60
Intranuclear esosinophilc droplet-like bodies
Cowdry type A bodies (HSV or VZV)
61
Iron-containing nodules in alveolar septum
Ferruginous bodies (asbestosis: increase chance of mesothelioma)
62
Keratin pearls on skin biopsy
Squamous cell carcinoma
63
Large granules in phagocytes, immunodeficiency
Chédiak-Higashi Disease (congenital failure of phagolysosome formation)
64
"Lead pipe" appearance of colon on abdominal imaging
Ulcerative colitis (loss of haustra)
65
Linear appearance of IgG deposition on glomerularnand alveolar basement membranes
Goodpasture syndrome
66
Low serum ceruloplasmin
Wilson disease (hepatolenticular degeneration)
67
"Lumpy bumpy" appearance of glomeruli on immunofluorescence
Poststreptoccal glomerulonephritis (due to deposition of IgG, IgM and C3)
68
Lytic "punched out" bone lesion on x-ray
Multiple Myeloma
69
Mammary gland ("blue domed") cyst
Fibrocystic change of the breast
70
Monoclonal antibody spike
- Multiple myeloma (usually IgG or IgA)
- Monoclonal gammopathy of undetermined significance (MGUS consequence of aging)
- Waldenström (M protein= IgM) macroglobulinemia
- Primary amyloidosis
71
Mucin-filled cell with peripheral nucleus
"Signet ring" (gastric carcinoma)
72
Narrowing of bowel lumen on barium X-ray
String sign (Crohn Disease)
73
Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis
Granulomatosis with polyangitis (Wegener; PR3-ANCA/c-ANCA)
Goodpasture syndrome (anti-basement membrane antibodies)
74
Needle shaped, negative birefringrnt crystals
Gout (monosodium urate crystals)
75
Nodular hyaline deposits in glomeruli
Kimmelstiel-Wilson nodules (diabetic nephropathy)
76
Novobocin response
Sensitive: S.epidermidis
Resistant: S.saprophyticus
77
"Nutmeg" appearance of liver
Chronic passive congestion of liver due to right heart failure or Budd-Chiari Syndrome
78
"Onion skin" periosteal reaction
Ewing sarcoma (malignant small blue cell tumor)
79
Optochin response
Sensitive: S.pnuemoniae
Resistant: Viridans strep (s.mutans, S.sanguis)
80
Periosteum raised from bone, creating triangular area
Cod an triangle on X-ray , Ewing sarcoma, pyogenic osteomyelitis
81
Podocyte fusion or effacement on electron microscopy
Minimal change Disease (child with nephrotic syndrome)
82
Polished, "ivory-like" appearance of bone at cartilage erosion
Eburnation (osteoarthritis resulting in bony Sclerosis)
83
Protein aggregates in neurons from hyperphosphorylation of tau protein
Neurofibrillary tangles (Alzheimer Disease) and Pick bodies (Pick Disease)
84
Psammoma bodies
Meninigiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of the endometrium and ovary
85
Pseudopalisading tumor on brain biopsy
Glioblastoma Multiforme
86
RBc casts in urine
Glomerulonephritis
87
Rectangular, crystal like, cytoplasmic inclusions in Leydig cells
Reinke crystals (Leydig cell tumor)
88
Recurrent infections, eczema, thrombocytopenia
Wiskott-Aldrich syndrome
89
Renal epithelial casts in urine
Intrinsic renal failure (ischemic or toxic)
90
Rhomboid crystals, positively birefringent
Psuedogout (calcium pyrophosphate dihydrate crystals)
91
Rib notching
Coarctaion of the aorta
92
Ring enhancing brain lesions in AIDS
Toxoplasma gondii, CNS lymphoma
93
Sheets of medium sized lymphoid cells with scattered pale, tangible body-laden macrophages ("starry sky" histology)
Burkitt lymphoma (t[8:14] c-myc activation, associated with EBV; "starry sky" made up of malignant cells)
94
Silver-staining spherical aggregation of tau proteins in neurons
Pick bodies (pick Disease: progressive dementia, changes in personality)
95
Soap bubble in femur or tibia on X-ray
Giant cell tumor of bone (generally benign)
96
"Spikes" on basement membrane "dome-like" subepithelial deposits
Membranous nephropathy (nephrotic syndrome)
97
Stacks of RBCs
Rouleaux formation (high ESR, multiple myeloma)
98
"Steeple" sign on CXR
Croup (parainfluenza virus)
99
Stipples vaginal epithelial cells
"Clue cells" (Gardnerella vaginalis)
100
Streptococcus bovis bacteremia
Colon cancer
101
"Tennis racket-shaped cytoplasmic organelles in Langerhans cells
Birbeck granules (langerhans cell histiocytosis)
102
Thousands of polyps on colonoscopy
Familial adenomatous polyposis (AD mutation of APC gene)
103
Thrombi made of white/red layers
Lines of Zahn (arterial thrombus, layers of platelets/RBCs)
104
"Thumb sign" on lateral neck X-ray
Epiglottitis (H.influenza)
105
Thyroid-like appearance of kidney
Chronic pyelonephritis (usually due to recurrent infections)
106
"Tram-track" appearance of capillary loops of glomerular basement membranes on light microscopy
Membranoproliferative glomerulonephritis
107
Triglyceride accumulation in liver cell vacuoles
Fatty liver disease (alcoholic or metabolic syndrome)
108
Waxy casts with very low urine flow
Chronic end stage renal disease
109
WBC casts in urine
Acute pyelonephritis
110
WBCs that look smudged
CLL (almost always B cell)
111
"Wire loop" glomerular capillary appearance on light microscopy
Diffuse glomerulonephritis (usually seen with lupus)
112
Yellowish CSF
Xanthochromia (e.g. Due to subarachnoid hemorrhage)
