Classic Labs/Findings Flashcards
1
Q
Decreased AFP in amniotic fluid/maternal serum
A
Down syndrome or other chromosomal abnormalities
2
Q
Large granules in phagocytes, immunodeficiency
A
Chediak-Higashi disease (congenital failure of phagolysosome formation)
3
Q
Recurrent infections, eczema, thrombocytopenia
A
Wiskott-Aldrich syndrome
4
Q
Branching Gm+ rods with sulfur granules
A
Actinomyces israelii
5
Q
Optochin sensitivity
A
Sensitive: S. pneumo
Resistant: S. viridans, (mutans & sanguis)
6
Q
Novobiocin response
A
Sensitive: S. epidermidis
Resistant: S. saprophiticus (resistant to my novo sappyness)
7
Q
Bacitracin response
A
Sensitive: S. pyogenes (GAS)
Resistant: S. agalactiae (GBS)
8
Q
S. bovis bacteremia is associated with which cancer?
A
Colon cancer
9
Q
Hilar LAD, peripheral granulamatous lesion in middle or lower lung lobes (can calcify)
A
Ghon complex (primary TB: Mycobacterium bacilli)
10
Q
Bacteria-covered vaginal epithelial cells
A
Clue cells (Gardnarella vaginalis)
11
Q
Ring-enhancing brain lesion on CT/MRI in AIDS
A
Toxoplasma gondii, CNS lymphoma
12
Q
Cardiomegaly with apical atrophy
A
Chagas disease (T cruzi)
13
Q
Heterophile antibodies
A
Infectious mono (EBV)
14
Q
Intranuclear inclusion bodies in cytoplasm of hippocampal and cerebellar neurons
A
Negri bodies of rabies
15
Q
Atypical lymphocytes
A
EBV
16
Q
Enlarged cells with intranuclear inclusion bodies
A
Owl eye appearance of CMV
17
Q
Thumb sign on lateral neck x-ray
A
Epiglottitis (H. influenzae)
18
Q
Delta wave on ECG, short PR interval, supraventricular tachycardia
A
WPW syndrome (Bundle of Kent bypasses AV node)
19
Q
Boot-shaped heart on x-ray
A
Tetralogy of Fallot
20
Q
Rib notching (inferior surface, on x-ray)
A
Coarctation of the aorta
21
Q
Heart nodules (granulomatous)
A
Aschoff bodies (rheumatic fever)
22
Q
Electrical alternans (alternating amplitude on ECG)
A
Pericardial tamponade
23
Q
HTN, hypokalemia, metabolic alkalosis
A
Primary hyperaldosteronism (Conn syndrome)
24
Q
Enlarged thyroid cells with ground glass nuclei with central clearing
A
Orphan Annie eyes nuclei (papillary carcinoma of the thyroid)
25
Antineutrophil cytoplasmic antibodies (ANCAs)
1. Microscopic polyangiitis and eosinophilic granulomatosis with polyangiitis (MPO-ANCA/p-ANCA)
2. Wegener's polyangiitis (PR3-ANCA/c-ANCA)
3. Primary sclerosing cholangitis (MPO-ANCA/p-ANCA)
26
Mucin-filled cell with peripheral nucleus
"Signet ring" (gastric carcinoma)
27
Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies
Celiac disease (diarrhea, WL)
28
Narrowing of bowel lumen on barium x-ray
"String sign" Crohn's disease
29
Lead pipe appearance of colon on abdominal imaging
UC (loss of haustra)
30
Thousands of polyps on colonoscopy
FAP (AD mutation of APC gene)
31
Apple core lesion on barium enema x-ray
Colorectal cancer (usually left-sided)
32
Eosinophilic cytoplasmic inclusion in liver cell
Mallory body (alcoholic liver disease)
33
Triglyceride accumulation in liver cell vacuoles
Fatty liver disease (alcoholic or metabolic syndrome)
34
Nutmeg appearance of liver
Chronic passive congestion of liver due to RHF or Budd-Chiari Syndrome
35
Antimitochondrial antibodies (AMAs)
Primary biliary cirrhosis (female, cholestasis, portal HTN)
36
Low serum ceruloplasmin
Wilson disease (hepatolenticular degeneration; Kayser-Fleischer rings due to copper accumulation)
37
Migratory thrombophlebitis (leading to migrating DVTs and vasculitis)
Trosseau syndrome (adenocarcinoma of pancreas or lung)
38
Basophilic nuclear remnants in RBCs
Howell-Jolly bodies (due to splenectomy or nonfunctional spleen)
39
Hypochromic, microcytic anemia
1. Iron deficiency anemia
2. Lead poisoning
3. Thalassemia (fetal Hb sometimes present)
40
Basophilic stippling of RBCs
Lead poisoning or sideroblastic anemia
41
Hair on end (crew-cut) appearance on x-ray
B-thalassemia, sickle cell disease (marrow expansion)
42
Hypersegmented neutrophils
Megaloblastic anemia
- B12: neurologic symptoms
- folate: no neurologic symptoms
43
Antiplatelet antibodies
ITP
44
High level of d-dimers
1. DVT
2. PE
3. DIC
45
Giant B cells with bilobed nuclei with prominent inclusions (owl's eye)
Reed-Sternberg cells (Hodgkin lymphoma)
46
Sheets of medium-sized lymphoid cells with scattered, pale, tingible body-laden macrophages (starry-sky histology)
Burkitt lymphoma (8;14) c-myc activation, associated with EBV (starry sky is made up of malignant cells)
47
Lytic (punched out) bone lesions on x-ray
Multiple myeloma
48
Monoclonal antibody spike
1. Multiple myeloma (usually IgG or IgA)
2. Monoclonal gammopathy of undetermined significance (MGUS consequence of ageing)
3. Waldenstrom (M protein = IgM) macroglobulinemia
4. Primary amyloidosis
49
Stacks of RBCs
Rouleaux formation (high ESR, MM)
50
Azurophilic peroxidase+ granular inclusions in granulocytes and myeloblasts
Auer rods (AML, esp promyelocytic)
51
WBCs that look smudged
CLL (almost always B cell)
52
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells
Birbeck granules (Langerhans cell histiocytosis)
53
"Brown" tumor of bone
1. Hyperparathyroidism
| 2. Osteitis fibrosa cystica (deposited hemosiderin from hemorrhage gives brown color)
54
Raised periosteum (creating a Codman triangle)
Aggressive bone lesion (eg: osteosarcoma, Ewing sarcoma, osteomyelitis)
55
Soap bubble in femur or tibia on x-ray
Giant cell tumor of bone (generally benign)
56
Onion skin periosteal reaction
Ewing sarcoma (malignant small blue cell tumor)
57
Anti-IgG antibodies
RA
58
Rhomboid crystals, +birefringent
Pseudogout (calcium pyrophosphate dihydrate crystals)
59
Needle-shaped, -birefringent crystals
Gout (monosodium urate crystals)
60
Elevated uric acid levels
1. Gout
2. Lesch-Nyhan syndrome
3. Tumor lysis syndrome
4. Loop and thiazide diuretics
61
Bamboo spine on x-ray
Ankylosing spondylitis (B-27)
62
ANA: anti-Smith and anti-dsDNA
SLE (Type III hypersensitivity)
63
Anti-topoisomerase antibodies
Diffuse systemic scleroderma
64
Keratin pearls on skin biopsy
Squamous cell carcinoma
65
Antihistone antibodies
Drug-induced SLE
- Hydralazine
- Isoniazid
- Phenytoin
- Procainamide
66
Bloody or yellow tap on lumbar puncture
Subarachnoid hemorrhage
67
Yellowish CSF
Xanthochromia (eg due to subarachnoid hemorrhage)
68
Eosinophilic cytoplasmic inclusion in neuron
Lewy body
- Parkinson's
- Lewy body dementia
69
Extracellular amyloid deposition in gray matter of brain
Senile plaques (Alzheimer's disease)
70
Depigmentation of neurons in substantia nigra
Parkinson disease
71
Protein aggregates in neurons from hyperphosphorylation of tau protein
1. Neurofibrillary tangles (Alzheimer's disease)
| 2. Pick bodies (Pick disease)
72
Pseudopalisading tumor cells on brain biopsy
Glioblastoma multiforme
73
Circular grouping of dark tumor cells surrounding pale neurofibrils
Homer-Wright rosettes (neuroblastoma, medulloblastoma)
74
Waxy casts with very low urine flow
Chronic end-stage renal disease
75
RBC casts in urine
Glomerulonephritis
76
Tram-track appearance of capillary loops of glomerular basement membranes on light microscopy
Membranoproliferative glomerulonephritis
77
Nodular hyaline deposits in glomeruli
Kimmelstiel-Wilson nodules (diabetic nephropathy)
78
Podocyte fusion or effacement on electron microscopy
Minimal change disease (child with nephrotic syndrome)
79
Spikes on BM, dome-like subepithelial deposits
Membranous nephropathy (nephrotic syndrome)
80
Anti-glomerular BM antibodies
Goodpasture syndrome (glomerulonephritis and hemoptysis)
81
Cellular crescents in Bowman's capsule
Rapidly progressive crescentic glomerulonephritis
82
Wire loop glomerular capillary appearance on light microscopy
Diffuse proliferative glomerulonephritis (usually seen with lupus)
83
Linear appearance of IgG deposition on glomerular and alveolar BMs
Goodpasture syndrome
84
Lumpy bumpy appearance of glomeruli on immunofluorescence
Postrep glomerulonephritis (due to deposition of IgG, IgM, and C3)
85
Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis
1. Granulomatosis with polyangiitis
| 2. Goodpasture syndrome
86
Thyroid-like appearance of kidney
Chronic pyelonephritis (usually due to recurrent infections)
87
WBC casts in urine
Acute pyelonephritis
88
Renal epithelial casts in urine
Intrinsic renal failure (eg: ischemia or toxic injury)
89
hCG elevated
1. Choriocarcinoma
| 2. Hyditaform mole
90
Dysplastic squamous cervical cells with raisinoid nuclei and hyperchromasia
Koilocytes (HPV: predisposes to cervical cancer)
91
Psammoma bodies
1. Meningiomas
2. Papillary thyroid carcinoma
3. Mesothelioma
4. Papillary serous carcinoma of endometrium and ovary
92
Disarrayed granulosa cells arranged around collections of eosinophilic fluid
Call-Exner bodies (granulosa cell tumor of the ovary)
93
Chocolate cyst of ovary
Endometriosis
94
Mammary gland (blue-domed) cyst
Fibrocystic change of breast
95
Glomerulus-like structure surrounding vessel in germ cells
Schiller-Duval bodies (yolk sac tumor)
96
Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells
Reinke crystals (Leydig cell tumor)
97
Thrombi made of white/red layers
Lines of Zahn (arterial thrombus, layers of platelets/RBCs)
98
Hexagonal, double-pointed, needle-like crystals in bronchial secretions
Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)
99
Desquamated epithelium casts in sputum
Curschmann spirals (bronchial asthma; can results in whorled mucous plugs)
100
Honeycomb lung on x-ray or CT
Interstitial pulmonary fibrosis
101
Desquamated epithelium casts in sputum
Curschmann spirals (bronchial asthma, can result in whorled mucuous plugs)
102
Colonies of Pseudomonas in lungs
CF
103
Iron-containing nodules in alveolar septum
Ferruginous bodies (asbestosis: increased chance of lung cancer)
104
Bronchogenic apical lung tumor on imaging
Pancoast tumor (can compress cervical sympathetic chain and cause Horner syndrome)
