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Rapid Review > Classic Labs/Findings > Flashcards

Classic Labs/Findings Flashcards

1
Q

Decreased AFP in amniotic fluid/maternal serum

A

Down syndrome or other chromosomal abnormalities

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2
Q

Large granules in phagocytes, immunodeficiency

A

Chédiak-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 pneumoniae; resistant: viridans streptococci

S mutans, S sanguis

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6
Q

Novobiocin response

A

Sensitive: S epidermidis; resistant: S saprophyticus

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7
Q

Bacitracin response

A

Sensitive: S pyogenes (group A); resistant: S agalactiae

group B

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8
Q

Streptococcus bovis bacteremia

A

Colon cancer

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9
Q

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

A

Ghon complex (1° TB: Mycobacterium bacilli)

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10
Q

Bacteria-covered vaginal epithelial cells

A

“Clue cells” (Gardnerella vaginalis)

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11
Q

Ring-enhancing brain lesion on CT/MRI in AIDS

A

Toxoplasma gondii, CNS lymphoma

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12
Q

Cardiomegaly with apical atrophy

A

Chagas disease (Trypanosoma cruzi)

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13
Q

Heterophile antibodies

A

Infectious mononucleosis (EBV)

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14
Q

Intranuclear eosinophilic droplet-like bodies

A

Cowdry type A bodies (HSV or VZV)

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15
Q

Eosinophilic globule in liver

A

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

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16
Q

“Steeple” sign on frontal CXR

A

Croup (parainfluenza virus)

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17
Q

Eosinophilic inclusion bodies in cytoplasm of

hippocampal and cerebellar neurons

A

Negri bodies of rabies

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18
Q

Atypical lymphocytes

A

EBV

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19
Q

Enlarged cells with intranuclear inclusion bodies

A

“Owl eye” appearance of CMV

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20
Q

“Thumb sign” on lateral neck x-ray

A

Epiglottitis (Haemophilus influenzae)

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21
Q

“Delta wave” on ECG, short PR interval, supraventricular

tachycardia

A

Wolff-Parkinson-White syndrome (Bundle of Kent

bypasses AV node)

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22
Q

“Boot-shaped” heart on x-ray

A

Tetralogy of Fallot (due to RVH)

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23
Q

Rib notching (inferior surface, on x-ray)

A

Coarctation of the aorta

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24
Q

Heart nodules (granulomatous)

A

Aschoff bodies (rheumatic fever)

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25
Q

Electrical alternans (alternating amplitude on ECG)

A

Pericardial tamponade

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26
Q

Hypertension, hypokalemia, metabolic alkalosis

A

1° hyperaldosteronism (Conn syndrome)

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27
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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28
Q

Antineutrophil cytoplasmic antibodies (ANCAs)

A

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

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29
Q

Mucin-filled cell with peripheral nucleus

A

“Signet ring” (gastric carcinoma)

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30
Q

Anti-transglutaminase/anti-gliadin/anti-endomysial

antibodies

A

Celiac disease (diarrhea, weight loss)

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31
Q

Narrowing of bowel lumen on barium x-ray

A

“String sign” (Crohn disease)

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32
Q

“Lead pipe” appearance of colon on abdominal imaging

A

Ulcerative colitis (loss of haustra)

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33
Q

Thousands of polyps on colonoscopy

A

Familial adenomatous polyposis (autosomal dominant,

mutation of APC gene)

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34
Q

“Apple core” lesion on barium enema x-ray

A

Colorectal cancer (usually left-sided)

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35
Q

Eosinophilic cytoplasmic inclusion in liver cell

A

Mallory body (alcoholic liver disease)

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36
Q

Triglyceride accumulation in liver cell vacuoles

A

Fatty liver disease (alcoholic or metabolic syndrome)

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37
Q

“Nutmeg” appearance of liver

A

Chronic passive congestion of liver due to right heart

failure or Budd-Chiari syndrome

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38
Q

Antimitochondrial antibodies (AMAs)

A

1° biliary cirrhosis (female, cholestasis, portal

hypertension)

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39
Q

Low serum ceruloplasmin

A 
Wilson disease (hepatolenticular degeneration; Kayser-
Fleischer rings due to copper accumulation)
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40
Q 
Migratory thrombophlebitis (leading to migrating DVTs
and vasculitis)
A

Trousseau syndrome (adenocarcinoma of pancreas or lung)

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41
Q

Basophilic nuclear remnants in RBCs

A

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

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42
Q

Hypochromic, microcytic anemia

A

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

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43
Q

Basophilic stippling of RBCs

A

Lead poisoning or sideroblastic anemia

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44
Q

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

A

β-thalassemia, sickle cell disease (marrow expansion)

45
Q

Hypersegmented neutrophils

A 
Megaloblastic anemia (B12 deficiency: neurologic
symptoms; folate deficiency: no neurologic symptoms)
46
Q

Antiplatelet antibodies

A

Idiopathic thrombocytopenic purpura

47
Q

High level of D-dimers

A

DVT, PE, DIC

48
Q

Giant B cells with bilobed nuclei with prominent

inclusions (“owl’s eye”)

A

Reed-Sternberg cells (Hodgkin lymphoma)

49
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)
50
Q

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

A

Multiple myeloma

51
Q

Monoclonal antibody spike

A
  • Multiple myeloma (usually IgG or IgA)
  • Monoclonal gammopathy of undetermined significance (MGUS consequence of aging)
  • Waldenström (M protein = IgM) macroglobulinemia
  • Primary amyloidosis
52
Q

Stacks of RBCs

A

Rouleaux formation (high ESR, multiple myeloma)

53
Q

Azurophilic peroxidase ⊕ granular inclusions in

granulocytes and myeloblasts

A

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

54
Q

WBCs that look “smudged”

A

CLL (almost always B cell)

55
Q

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

A

Birbeck granules (Langerhans cell histiocytosis)

56
Q

“Brown” tumor of bone

A

Hyperparathyroidism or osteitis fibrosa cystica (deposited

hemosiderin from hemorrhage gives brown color)

57
Q

Raised periosteum (creating a “Codman triangle”)

A

Aggressive bone lesion (eg, osteosarcoma, Ewing

sarcoma, osteomyelitis)

58
Q

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

A

Giant cell tumor of bone (generally benign)

59
Q

“Onion skin” periosteal reaction

A

Ewing sarcoma (malignant small blue cell tumor)

60
Q

Anti-IgG antibodies

A 
Rheumatoid arthritis (systemic inflammation, joint
pannus, boutonniere and swan neck deformities)
61
Q

Rhomboid crystals, ⊕ birefringent

A

Pseudogout (calcium pyrophosphate dihydrate crystals)

62
Q

Needle-shaped, ⊝ birefringent crystals

A

Gout (monosodium urate crystals)

63
Q

Increased uric acid levels

A

Gout, Lesch-Nyhan syndrome, tumor lysis syndrome,

loop and thiazide diuretics

64
Q

“Bamboo spine” on x-ray

A

Ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27)

65
Q

Antinuclear antibodies (ANAs: anti-Smith and antidsDNA)

A

SLE (type III hypersensitivity)

66
Q

Anti-topoisomerase antibodies

A

Diffuse systemic scleroderma

67
Q

Keratin pearls on a skin biopsy

A

Squamous cell carcinoma

68
Q

Antihistone antibodies

A

Drug-induced SLE (eg, hydralazine, isoniazid,

phenytoin, procainamide)

69
Q

Bloody or yellow tap on lumbar puncture

A

Subarachnoid hemorrhage

70
Q

Yellowish CSF

A

Xanthochromia (eg, due to subarachnoid hemorrhage)

71
Q

Eosinophilic cytoplasmic inclusion in neuron

A

Lewy body (Parkinson disease and Lewy body dementia)

72
Q

Extracellular amyloid deposition in gray matter of brain

A

Senile plaques (Alzheimer disease)

73
Q

Depigmentation of neurons in substantia nigra

A 
Parkinson disease (basal ganglia disorder: rigidity, resting
tremor, bradykinesia)
74
Q

Protein aggregates in neurons from hyperphosphorylation of tau protein

A 
Neurofibrillary tangles (Alzheimer disease) and Pick
bodies (Pick disease)
75
Q

Silver-staining spherical aggregation of tau proteins in neurons

A 
Pick bodies (Pick disease: progressive dementia, changes
in personality)
76
Q

Pseudopalisading tumor cells on brain biopsy

A

Glioblastoma multiforme

77
Q

Circular grouping of dark tumor cells surrounding pale neurofibrils

A

Homer-Wright rosettes (neuroblastoma, medulloblastoma)

78
Q

“Waxy” casts with very low urine flow

A

Chronic end-stage renal disease

79
Q

RBC casts in urine

A

Glomerulonephritis

80
Q

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

A

Membranoproliferative glomerulonephritis

81
Q

Nodular hyaline deposits in glomeruli

A

Kimmelstiel-Wilson nodules (diabetic nephropathy)

82
Q

Podocyte fusion or “effacement” on electron microscopy

A

Minimal change disease (child with nephrotic syndrome)

83
Q

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

subepithelial deposits

A

Membranous nephropathy (nephrotic syndrome)

84
Q

Anti–glomerular basement membrane antibodies

A 
Goodpasture syndrome (glomerulonephritis and
hemoptysis)
85
Q

Cellular crescents in Bowman capsule

A

Rapidly progressive crescentic glomerulonephritis

86
Q

“Wire loop” glomerular capillary appearance on light

microscopy

A

Diffuse proliferative glomerulonephritis (usually seen

with lupus)

87
Q

Linear appearance of IgG deposition on glomerular and alveolar basement membranes

A

Goodpasture syndrome

88
Q

“Lumpy bumpy” appearance of glomeruli on

immunofluorescence

A 
Poststreptococcal glomerulonephritis (due to deposition
of IgG, IgM, and C3)
89
Q 
Necrotizing vasculitis (lungs) and necrotizing
glomerulonephritis
A

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

90
Q

Thyroid-like appearance of kidney

A 
Chronic pyelonephritis (usually due to recurrent
infections)
91
Q

WBC casts in urine

A

Acute pyelonephritis

92
Q

Renal epithelial casts in urine

A

Intrinsic renal failure (eg, ischemia or toxic injury)

93
Q

hCG elevated

A

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

94
Q

Dysplastic squamous cervical cells with “raisinoid” nuclei and hyperchromasia

A

Koilocytes (HPV: predisposes to cervical cancer)

95
Q

Psammoma bodies

A

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

96
Q

Disarrayed granulosa cells arranged around collections of eosinophilic fluid

A

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

97
Q

“Chocolate cyst” of ovary

A

Endometriosis (frequently involves both ovaries)

98
Q

Mammary gland (“blue domed”) cyst

A

Fibrocystic change of the breast

99
Q

Glomerulus-like structure surrounding vessel in germ

cells

A

Schiller-Duval bodies (yolk sac tumor)

100
Q

Rectangular, crystal-like, cytoplasmic inclusions in Leydig

cells

A

Reinke crystals (Leydig cell tumor)

101
Q

Thrombi made of white/red layers

A

Lines of Zahn (arterial thrombus, layers of platelets/

RBCs)

102
Q

Hexagonal, double-pointed, needle-like crystals in

bronchial secretions

A 
Bronchial asthma (Charcot-Leyden crystals: eosinophilic
granules)
103
Q

Desquamated epithelium casts in sputum

A 
Curschmann spirals (bronchial asthma; can result in
whorled mucous plugs)
104
Q

“Honeycomb lung” on x-ray or CT

A

Interstitial pulmonary fibrosis

105
Q

Colonies of mucoid Pseudomonas in lungs

A 
Cystic fibrosis (autosomal recessive mutation in CFTR
gene --> fat-soluble vitamin deficiency and mucous plugs)
106
Q

Iron-containing nodules in alveolar septum

A

Ferruginous bodies (asbestosis: increased chance of lung cancer)

107
Q

Bronchogenic apical lung tumor on imaging

A 
Pancoast tumor (can compress cervical sympathetic chain
and cause Horner syndrome)
108
Q

Degeneration of dorsal column fibers

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

Rapid Review (5 decks)

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