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Rapid Review > Classic Labs/Findings > Flashcards

Classic Labs/Findings Flashcards

1
Q

Low AFP in amniotic fluid/maternal serum

A

Down syndrome or other chromosomal abnormality

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2
Q

Large granules in phagocytes, immunodeficiency

A

Chediak-Higashi disease (congenital failure of phagolysosome formation)

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3
Q

Recurrent infections, eczema, thrombocytopenia

A

Wiskott-Aldrich syndrome

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4
Q

Branching gram + rods with sulfur granules

A

Actinomyces israelii

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5
Q

Optochin sensitivity

A

Sensitive: S pneumo; resistant: viridans strep (S mutans, S sanguis)

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6
Q

Novobiocin response

A

Sensitive: S epi, resistant: S agalactiae (group B)

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7
Q

Strep bovis bacteremia

A

Colon cancer

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8
Q

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

A

Ghon complex (primary TB - mycobacterium bacilli)

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9
Q

Bacteria-covered vaginal epithelial cells

A

“Clue cells” (Gardnerella vaginalis)

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10
Q

Ring-enhancing brain lesion on CT/MRI in AIDS

A

Toxoplasma gondii, CNS lymphoma

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11
Q

Cardiomegaly with atypical atrophy

A

Chagas disease (Trypanosoma cruzi)

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12
Q

Heterophile antibodies

A

Infectious mononucleosis (EBV)

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13
Q

Intranuclear eosinophilic droplet-like bodies

A

Cowdry type A bodies (HSV or VZV)

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14
Q

Eosinophilic globule in liver

A

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

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15
Q

“Steeple” sign on frontal CXR

A

Croup (parainfluenza virus)

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16
Q

Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar neurons

A

Negri bodies of rabies

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17
Q

Atypical lymphocytes

A

EBV

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18
Q

Enlarged cells with intranuclear inclusion bodies

A

“Owl eye” appearance of CMV

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19
Q

“Thumb sign” on lateral neck x-ray

A

Epiglottitis (H flu)

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20
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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21
Q

“Boot-shaped” heart on x-ray

A

Tetralogy of Fallot (due to RVH)

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22
Q

Rib notching (inferior surface, on x-ray)

A

Coarctation of the aorta

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23
Q

Heart nodules (granulomatous)

A

Aschoff bodies (rheumatic fever)

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24
Q

Electrical alternans (alternating amplitude on EKG)

A

Pericardial tamponade

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25
Q

Hypertension, hypokalemia, metabolic alkalosis

A

Primary hyperaldosteronism (Conn syndrome)

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26
Q

Enlarged thyroid cells with ground-glass nuclei with central clearing

A

“Orphan Annie” eyes nuclei

in papillary carcinoma of the thyroid

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27
Q

ANCAs (antineutrophil cytoplasmic antibodies)

A

Microscopic polyangiitis and eosinophilic granulomatosis with polyangiitis (MPO-ANCA/p-ANCA)
granulomatosis with polyangiitis (Wegener; PR3-ANCA/c-ANCA)
primary sclerosing cholangitis (MPO-ANCA/p-ANCA)

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28
Q

Mucin-filled cell with peripheral nucleus

A

“Signet ring”

in gastric carcinoma

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29
Q

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

A

Celiac disease

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30
Q

Narrowing of bowel lumen on barium x-ray

A

“String sign”

Seen in Crohn’s

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31
Q

“Lead pipe” appearance of colon on abdominal imaging

A

Loss of haustra in Ulcerative colitis

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32
Q

Thousands of polyps on colonoscopy

A

Familial adenomatous polyposis

Autosomal dominant, mutation of APC gene

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33
Q

“Apple core” lesion on barium enema x-ray

A

Colorectal cancer (usually left-sided)

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34
Q

Eosinophilic cytoplasmic inclusion in liver cell

A

Mallory body

Seen in alcoholic liver disease

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35
Q

Triglyceride accumulation in liver cell vacuoles

A

Fatty liver disease

In alcoholic or metabolic syndrome

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36
Q

“Nutmeg” appearance of liver

A

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

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37
Q

Antimitochondrial antibodies (AMAs)

A

Seen in primary biliary cirrhosis (typically female, cholestasis, portal hypertension)

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38
Q

Low serum ceruloplasmin

A

Wilson’s Disease

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39
Q

Migratory thrombophlebitis (leading to migrating DVTs and vasculitis)

A

Trousseau Syndrome (adenocarcinoma of pancreas or lung)

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40
Q

Basophilic nuclear remnants in RBCs

A

Howell-Jolly bodies

2/2 splenectomy or nonfunctional spleen

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41
Q

Hypochromic, microcytic anemia

A

Iron deficiency anemia
Lead poisoning
Thalassemia

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42
Q

Basophilic stippling of RBCs

A

Lead poisoning or sideroblastic anemia

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43
Q

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

A

Beta-thalassemia

Sickle cell disease (marrow expansion)

44
Q

Hypersegmented neutrophils

A

Megaloblastic anemia (b12 def, folate def)

45
Q

Antiplatelet antibodies

A

Idiopathic thrombocytopenic purpura

46
Q

High level of D-dimers

A

DVT, PE, DIC

47
Q

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

A

Reed-Sternberg cells

Characteristic of Hodgkin lymphoma

48
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 EBV)
"starry sky" made up of malignant cells
49
Q

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

A

Multiple myeloma

50
Q

Monoclonal antibody spike

A

Multiple myeloma (usually IgG or IgA)
MGUS
Waldenstrom macroglobulinemia
Primary amyloidosis

51
Q

Stacks of RBCs

A

Rouleaux formation (high ESR, multiple myeloma)

52
Q

Azurophilic peroxidase + granular inclusions in granulocytes and myeloblasts

A

Auer rods

Seen in AML, epsecially the promyelocytic type

53
Q

WBCs that look “smudged”

A

CLL (almost always B cell)

54
Q

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

A

Birbeck granules

Seen in Langerhans cell histiocytosis

55
Q

“Brown” tumor of bone

A

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

56
Q

Raised periosteum (creating a “Codman triangle”)

A

Aggressive bone lesion (eg osteosarcoma, Ewing sarcoma, osteomyelitis)

57
Q

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

A

Giant cell tumor of bone (generally benign)

58
Q

“Onion skin” periosteal reaction

A

Ewing sarcoma (malignant small blue cell tumor)

59
Q

Anti-IgG antibodies

A

Rheumatoid arthritis (systemic inflammation, joint pannus, boutonniere, swan neck deformaties)

60
Q

Rhomboid crystals, +birefringent

A

Pseudogout (calcium pyrophosphate dihydrate crystals)

61
Q

Needle-shaped, - birefringent crystals

A

Gout (monosidum urate crystals)

62
Q

Increased uric acid levels

A

Gout
Lesch-Nyhan syndrome
Tumor lysis syndrome
Loop and thiazide diuretics

63
Q

“Bamboo spine” on x-ray

A

Ankylosing spondylitis (chronic inflammatory arthritis, assoc w/ HLA-B27)

64
Q

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

A

SLE (type III hypersensitivity)

65
Q

Anti-topoisomerase antibodies

A

Diffuse systemic scleroderma

66
Q

Keratin pearls on a skin biopsy

A

Squamous cell carcinoma

67
Q

Antihistone antibodies

A

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

68
Q

Bloody or yellow tap on lumbar puncture

A

Subarachnoid hemorrhage

69
Q

Yellowish CSF

A

Xanthochromia (eg due to subarachnoid hemorrhage)

70
Q

Eosinophilic cytoplasmic inclusion in neuron

A

Lewy Body (Parkinson disease and Lewy body dementia)

71
Q

Extracellular amyloid deposition in gray matter of brain

A

Senile plaques (Alzheimer disease)

72
Q

Depigmentation of neurons in substantia nigra

A

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

73
Q

Protein aggregates in neurons from hyperphosphorylation of tau protein

A

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

74
Q

Silver-staining spherical aggregation of tau proteins in neurons

A

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

75
Q

Pseudopalisading tumor cells on brain biopsy

A

GBM

76
Q

Circular grouping of dark tumor cells surrounding pale neurofibrils

A

Homer-Wright rosettes (neuroblastoma, medulloblastoma)

77
Q

“Waxy” casts with very low urine flow

A

Chronic end-stage renal disease

78
Q

RBC casts in urine

A

Glomerulonephritis

79
Q

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

A

Membranoproliferative glomerulonephritis

80
Q

Nodular hyaline deposits in glomeruli

A

Kimmelstiel-Wilson nodules (diabetic nephropathy)

81
Q

Podocyte fusion or “effacement” on electron microscopy

A

Minimal change disease (child with nephrotic syndrome)

82
Q

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

A

Membranous nephropathy (nephrotic syndrome)

83
Q

Anti-glomerular basement membrane antibodies

A

Goodpasture syndrome (glomerulonephritis and hemoptysis)

84
Q

Cellular crescents in Bowman capsule

A

Rapidly progressive crescentic glomerulonephritis

85
Q

“Wire loop” glomerular capillary appearance on light microscopy

A

Diffuse proliferative glomerulonephritis (usually seen with lupus)

86
Q

Linear appearance of IgG deposition on glomerular and alveolar basement membranes

A

Goodpasture syndrome

87
Q

“Lumpy bumpy” appearance of glomeruli on immunofluorescence

A

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

88
Q

Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis

A

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

89
Q

Thyroid-like appearance of kidney

A

Chronic pyelonephritis (usually 2/2 recurrent infections)

90
Q

WBC casts in urine

A

Acute pyelonephritis

91
Q

Renal epithelial casts in urine

A

Intrinsic renal failure (eg ischemia or toxic injury)

92
Q

hCG elevated

A

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

93
Q

Dysplastic squamous cervical cells with “raisinoid” nuclei and hyperchromasia

A

Koilocytes (HPV: predisposes to cervical cancer)

94
Q

Psamomma bodies

A

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

95
Q

Disarrayed granulosa cells arranged around collections of eosinophilic fluid

A

Call-Exner bodies

Seen in granulosa cell tumor of the ovary

96
Q

“Chocolate cyst” of ovary

A

Endometriosis

Frequently involves both ovaries

97
Q

Mammary gland (“blue domed”) cyst

A

Fibrocystic change of the breast

98
Q

Glomerulus-like structure surrounding vessel in germ cells

A

Schiller-Duval bodies (yolk sac tumor)

99
Q

Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells

A

Reinke crystals (Leydig cell tumor)

100
Q

thrombi made of white/red layers

A

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

101
Q

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

A

Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)

102
Q

Desquamated epithelium casts in sputum

A

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

103
Q

“Honeycomb lung” on x-ray or CT

A

Interstitial pulmonary fibrosis

104
Q

Colonies of mucoid Pseudomonas in lungs

A

Cystic fibrosis

105
Q

Iron-containing nodules in alveolar septum

A

Ferruginous bodies

Seen in asbestosis, increasing chance of lung cancer

106
Q

Bronchogenic apical lung tumor on imaging

A

Pancoast tumor

Rapid Review (8 decks)

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