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Step 1 > Classic Labs/Findings > Flashcards

Classic Labs/Findings Flashcards

1
Q

Increased AFP in amniotic fluid/maternal serum

A

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

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2
Q

Anticentromere antibodies

A

Scleroderma (CREST)

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3
Q

Anti-desmoglein (anti-desmosome) antibodies

A

Pemphigus vulgaris (blistering)

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4
Q

Anti-glomerular basement membrane antibodies

A

Goodpasture syndrome (glomerulonephritis and hemoptysis)

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5
Q

Antihistone antibodies

A

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

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6
Q

Anti-IgG antibodies

A

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

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7
Q

Antimitochondrial antibodies (AMAs)

A

Primary biliary cirrhosis (female, cholestasis, portal hypertension)

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8
Q

Anitneutrophil Cytosplasmic Antibodies (ANCAs)

A

Microscopic polyangiitis and eosinophlic granulomatosis with polyangiitis (Churg-Strauss syndrome) (MPO-ANCA/p-ANCA); granulomatosis with polyangiitis (Wegener; PR3-ANCA/c-ANCA)

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9
Q

Antiplatelet antibodies

A

SLE (type III hypersensitivity)

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10
Q

Anti-topoisomerase antibodies

A

Diffuse systemic scleroderma

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11
Q

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

A

Celiac disease (diarrhea, weight loss)

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12
Q

“apple core” lesion of barium enema XR

A

Colorectal cancer (usually left sided)

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13
Q

Atypical lymphocytes

A

EBV

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14
Q

Azurophilic peroxidase positive granular inclusion in granulocytes and myeloblasts

A

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

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15
Q

Bacitracin response

A

Sensitive: S pyogenes (group A); resistance: S agalactiae (group B)

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16
Q

“Bamboo spine” on XR

A

Ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27)

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17
Q

Basophilic nuclear remnants in RBCs

A

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

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18
Q

Basophilic stippling of RBCs

A

Lead poisoning or sideroblastic anemia

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19
Q

Bloody or yellow tap on lumbar puncture

A

Subarachnoid hemorrhage

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20
Q

“boot-shaped” heart on XR

A

Tetralogy of Fallot (due to RVH)

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21
Q

Branching gram positive rods with sulfur granules

A

Actinomyces israelii

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22
Q

Bronchogenic apical lung tumor on imaging

A

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

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23
Q

Cardiomegaly with apical atrophy

A

Chagas disease (trypanosoma cruzi)

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24
Q

Cellular crescents in Bowman’s capsule

A

Rapidly progressive crescentic glomerulonephritis

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25
Q

“Chocolate cysts” of ovary

A

Endometriosis (frequently involves both ovaries)

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26
Q

Circular grouping of dark tumor cells surrounding pale neurofibrils

A

Homer-Wright rosettes (neuroblastoma, medulloblastoma)

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27
Q

Colonies of mucoid Pseudomonas in lungs

A

Cystic fibrosis (AR mutation in CFTR gene –> fat soluble vitamin deficiency and mucous plugs)

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28
Q

Decreased AFP in amniotic fluid/maternal serum

A

Down syndrome or other chromosomal abnormalities

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29
Q

Degeneration of dorsal column fibers

A

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

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30
Q

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

A

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

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31
Q

Depigmentation of neurons in the substantia nigra

A

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

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32
Q

Desquamated epithelium casts in sputum

A

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

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33
Q

Disarrayed granulosa cells arranged around collections of eosinophilic fluid

A

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

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34
Q

Dysplastic squamous cervical cells with “raisinoid” nuclei and hyperchromasia

A

Koilocytes (HPV: predisposes to cervical cancer)

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35
Q

Electrical alternans (alternating amplitude on EKG)

A

Pericardial tamponade

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36
Q

Enlarged cells with intranuclear inclusion bodies

A

“Owl eye” appearance of CMV

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37
Q

Enlarged thyroid cells with ground-glass nuclei with central clearing

A

“Orphan Annie” eyes nuclei (papillary carcinoma of the thyroid)

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38
Q

Eosinophilic cytoplasmic inclusion in liver cell

A

Mallory body (alcoholic liver disease)

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39
Q

Eosinophilic cytoplasmic inclusion in neuron

A

Lewy body (Parkinson disease and Lewy body dementia)

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40
Q

Eosinophilic globule in liver

A

Councilman body 9viral hepatitis, yellow fever), represents hepatocyte undergoing apoptosis

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41
Q

Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar neurons

A

Negri bodies of rabies

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42
Q

Extracellular amyloid deposition in gray matter of brain

A

Senile plaques (Alzheimer disease)

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43
Q

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

A

Reed-Sterberg cells (Hodgkin lymphoma)

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44
Q

Glomerulus-like structure surrounding vessel in germ cells

A

Schiller-Duval bodies (yolk sac tumor)

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45
Q

“Hair on end” (“Crew-cut”) appearance on XR

A

β-thalassemia, sickle cell disease (marrow expansion)

46
Q

hCG elevated

A

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

47
Q

Heart nodules (granulomatous)

A

Aschoff bodies (rheumatic fever)

48
Q

Heterophile antibodies

A

Infectious mononucleosis (EBV)

49
Q

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

A

Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)

50
Q

High level of D-dimers

A

DVT, PE, DIC

51
Q

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

A

Ghon complex (Primary TB: mycobacterium bacilli)

52
Q

“Honeycomb lung” on XR or CT

A

Interstitial pulmonary fibrosis

53
Q

Hypercoagulability (leading to migrating DVTs and vasculitis)

A

Trousseau syndrome (adenocarcinoma of pancreas or lung)

54
Q

Hypersegmented neutrophils

A

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

55
Q

Hypertension, hypokalemia, metabolic alkalosis

A

Primary hyperaldosteronism (Conn syndrome)

56
Q

Hypochromic, microcytic anemia

A

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

57
Q

Intranuclear eosinophilic droplet-like bodies

A

Cowddry type . bodies (HSV or VZV)

58
Q

Iron-containing nodule in alveolar septum

A

Ferruginous bodies (asbestosis: increased chance of mesothelioma)

59
Q

Keratin pearls on a skin biopsy

A

Squamous cell carcinoma

60
Q

Large granules in phagocytes, immunodeficiency

A

Chediak-Higashi disease (congenital failure of phagolysosome formation)

61
Q

“lead pipe” appearance of colon on abdominal imaging

A

Ulcerative colitis (loss of haustra)

62
Q

Linear appearance if IgG deposition of glomerular and alveolar basement membranes

A

Goodpasture syndrome

63
Q

Low serum ceruloplasmin

A

Wilson disease (hepatolenticular degeneration)

64
Q

“lumpy bumpy” appearance of glomeruli on immunofluorescence

A

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

65
Q

Lytic (punched-out) bone lesions on XR

A

Multiple myeloma

66
Q

Mammary gland (Blue-domed) cyst

A

fibrocystic change of the breast

67
Q

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

68
Q

Mucin-filled cell with peripheral nucleus

A

“Signet-ring” (gastric carcinoma)

69
Q

Narrowing of bowel lumen on barium XR

A

“String sign” (Crohn disease)

70
Q

Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis

A

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

71
Q

Needle-shaped, negative birefringent crystals

A

Gout (monosodium urate crystals)

72
Q

Nodular hyaline deposits in glomeruli

A

Kimmelstein-Wilson nodules (diabetic neuropathy)

73
Q

Novobiocin response

A

Sensitive: S. epidermidis; Resistant: S. saprophyticus

74
Q

“Nutmeg” liver

A

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

75
Q

“Onion skin” periosteal reaction

A

Ewing sarcoma (malignant small blue cell tumor)

76
Q

Optochin response

A

Sensitive: S. pneumoniae; Resistant: S. viridans (mutan,/sanguis)

77
Q

Podocyte fusion or “effacement” on electron microscopy

A

Minimal change disease (child with nephrotic syndrome)

78
Q

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

A

Eburnation (osteoarthritis resulting in bony sclerosis)

79
Q

Protein aggregates in neurons from hyperphosphorylation of tau protein

A

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

80
Q

Psammoma bodies

A

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

81
Q

Pseudopalisading tumor cells on brain biopsy

A

Glioblastoma multiforme

82
Q

Raised periosteum (creating a “Codman triangle”)

A

Aggressive bone lesion (ex: osteosarcoma, Ewing sarcoma, osteomyelitis)

83
Q

RBC casts in urine

A

Glomerulonephritis

84
Q

Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells

A

Reinke crystals (Leydig cell tumor)

85
Q

Recurrent infections, eczema, thrombocytopenia

A

Wiskott-Aldrich syndrome

86
Q

Renal epithelial casts in urine

A

Intrinsic renal failure (ex: ischemia or toxic injury)

87
Q

Rhomboid crystals, positive birefringence

A

Pseudogout (calcium pyrophospahte dihydrate crystals)

88
Q

Rib notching (inferior surface on XR)

A

Coarctation of the aorta

89
Q

Ring-enhancing brain lesion of CT/MRI and AIDS

A

Toxoplasma gondii, CNS lymphoma

90
Q

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 EBG; “starry sky” made up of malignant cells)

91
Q

Silver-staining spherical aggregation of tau proteins in neurons

A

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

92
Q

“Soap bubble” in femur or tibia on XR

A

Giant cell tumor of bone (generally benign)

93
Q

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

A

Membranous nephropathy (nephrotic syndrome)

94
Q

Stacks of RBCs

A

Rouleaux formation (high ESR, multiple myeloma)

95
Q

“Steeple” sign on frontal CXR

A

Croup (parainfluenza virus)

96
Q

Stippled vaginal epithelial cells

A

“Clue cells” (Gardnerella vaginalis)

97
Q

Streptococcus bovis bacteremia

A

Colon cancer

98
Q

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

A

Birbeck granules (Langerhans cell histiocytosis)

99
Q

Thousands of polyps on colonoscopy

A

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

100
Q

Thrombi made of white/red layers

A

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

101
Q

“Thumb sign” on lateral neck XR

A

Epiglottitis (Haemophilus influenzae)

102
Q

Thyroid-like appearance of kidney

A

Chronic pyelonephritis (usually due to recurrent infections)

103
Q

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

A

Membranoproliferative glomerulonephritis

104
Q

Triglyceride accumulation in liver cell vacuoles

A

Fatty liver disease (alcoholic or metabolic syndrome)

105
Q

Increased uric acid levels

A

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

106
Q

“Waxy” casts with very low urine flow

A

Chronic end-stage renal disease

107
Q

WBC casts in urine

A

Acute pyelonephritis

108
Q

WBCs that look “smudged”

A

Chronic Lymphocytic Leukemia (almost always B cell)

109
Q

“Wire loop” glomerular capillary appearance on light microscopy

A

Diffuse proliferative glomerulonephritis (usually seen in SLE)

110
Q

Yellowish CSF

A

Xanthochromia (ex: due to subarachnoid hemorrhages)

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