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

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 Gm+ rods with sulfur granules

A

Actinomyces israelii

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5
Q

Optochin sensitivity

A

Sensitive: S. pneumo
Resistant: S. viridans, (mutans & sanguis)

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6
Q

Novobiocin response

A

Sensitive: S. epidermidis
Resistant: S. saprophiticus (resistant to my novo sappyness)

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7
Q

Bacitracin response

A

Sensitive: S. pyogenes (GAS)
Resistant: S. agalactiae (GBS)

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8
Q

S. bovis bacteremia is associated with which cancer?

A

Colon cancer

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9
Q

Hilar LAD, peripheral granulamatous lesion in middle or lower lung lobes (can calcify)

A

Ghon complex (primary TB: Mycobacterium bacilli)

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10
Q

Bacteria-covered vaginal epithelial cells

A

Clue cells (Gardnarella 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 (T cruzi)

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13
Q

Heterophile antibodies

A

Infectious mono (EBV)

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14
Q

Intranuclear inclusion bodies in cytoplasm of hippocampal and cerebellar neurons

A

Negri bodies of rabies

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15
Q

Atypical lymphocytes

A

EBV

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16
Q

Enlarged cells with intranuclear inclusion bodies

A

Owl eye appearance of CMV

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17
Q

Thumb sign on lateral neck x-ray

A

Epiglottitis (H. influenzae)

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18
Q

Delta wave on ECG, short PR interval, supraventricular tachycardia

A

WPW syndrome (Bundle of Kent bypasses AV node)

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19
Q

Boot-shaped heart on x-ray

A

Tetralogy of Fallot

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20
Q

Rib notching (inferior surface, on x-ray)

A

Coarctation of the aorta

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21
Q

Heart nodules (granulomatous)

A

Aschoff bodies (rheumatic fever)

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22
Q

Electrical alternans (alternating amplitude on ECG)

A

Pericardial tamponade

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23
Q

HTN, hypokalemia, metabolic alkalosis

A

Primary hyperaldosteronism (Conn syndrome)

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24
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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25
Q

Antineutrophil cytoplasmic antibodies (ANCAs)

A
  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)
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26
Q

Mucin-filled cell with peripheral nucleus

A

“Signet ring” (gastric carcinoma)

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27
Q

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

A

Celiac disease (diarrhea, WL)

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28
Q

Narrowing of bowel lumen on barium x-ray

A

“String sign” Crohn’s disease

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29
Q

Lead pipe appearance of colon on abdominal imaging

A

UC (loss of haustra)

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30
Q

Thousands of polyps on colonoscopy

A

FAP (AD mutation of APC gene)

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31
Q

Apple core lesion on barium enema x-ray

A

Colorectal cancer (usually left-sided)

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32
Q

Eosinophilic cytoplasmic inclusion in liver cell

A

Mallory body (alcoholic liver disease)

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33
Q

Triglyceride accumulation in liver cell vacuoles

A

Fatty liver disease (alcoholic or metabolic syndrome)

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34
Q

Nutmeg appearance of liver

A

Chronic passive congestion of liver due to RHF or Budd-Chiari Syndrome

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35
Q

Antimitochondrial antibodies (AMAs)

A

Primary biliary cirrhosis (female, cholestasis, portal HTN)

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36
Q

Low serum ceruloplasmin

A

Wilson disease (hepatolenticular degeneration; Kayser-Fleischer rings due to copper accumulation)

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37
Q

Migratory thrombophlebitis (leading to migrating DVTs and vasculitis)

A

Trosseau syndrome (adenocarcinoma of pancreas or lung)

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38
Q

Basophilic nuclear remnants in RBCs

A

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

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39
Q

Hypochromic, microcytic anemia

A
  1. Iron deficiency anemia
  2. Lead poisoning
  3. Thalassemia (fetal Hb sometimes present)
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40
Q

Basophilic stippling of RBCs

A

Lead poisoning or sideroblastic anemia

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41
Q

Hair on end (crew-cut) appearance on x-ray

A

B-thalassemia, sickle cell disease (marrow expansion)

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42
Q

Hypersegmented neutrophils

A

Megaloblastic anemia

  • B12: neurologic symptoms
  • folate: no neurologic symptoms
43
Q

Antiplatelet antibodies

A

ITP

44
Q

High level of d-dimers

A
  1. DVT
  2. PE
  3. DIC
45
Q

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

A

Reed-Sternberg cells (Hodgkin lymphoma)

46
Q

Sheets of medium-sized lymphoid cells with scattered, pale, tingible body-laden macrophages (starry-sky histology)

A

Burkitt lymphoma (8;14) c-myc activation, associated with EBV (starry sky is made up of malignant cells)

47
Q

Lytic (punched out) bone lesions on x-ray

A

Multiple myeloma

48
Q

Monoclonal antibody spike

A
  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
Q

Stacks of RBCs

A

Rouleaux formation (high ESR, MM)

50
Q

Azurophilic peroxidase+ granular inclusions in granulocytes and myeloblasts

A

Auer rods (AML, esp promyelocytic)

51
Q

WBCs that look smudged

A

CLL (almost always B cell)

52
Q

Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells

A

Birbeck granules (Langerhans cell histiocytosis)

53
Q

“Brown” tumor of bone

A
  1. Hyperparathyroidism

2. Osteitis fibrosa cystica (deposited hemosiderin from hemorrhage gives brown color)

54
Q

Raised periosteum (creating a Codman triangle)

A

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

55
Q

Soap bubble in femur or tibia on x-ray

A

Giant cell tumor of bone (generally benign)

56
Q

Onion skin periosteal reaction

A

Ewing sarcoma (malignant small blue cell tumor)

57
Q

Anti-IgG antibodies

A

RA

58
Q

Rhomboid crystals, +birefringent

A

Pseudogout (calcium pyrophosphate dihydrate crystals)

59
Q

Needle-shaped, -birefringent crystals

A

Gout (monosodium urate crystals)

60
Q

Elevated uric acid levels

A
  1. Gout
  2. Lesch-Nyhan syndrome
  3. Tumor lysis syndrome
  4. Loop and thiazide diuretics
61
Q

Bamboo spine on x-ray

A

Ankylosing spondylitis (B-27)

62
Q

ANA: anti-Smith and anti-dsDNA

A

SLE (Type III hypersensitivity)

63
Q

Anti-topoisomerase antibodies

A

Diffuse systemic scleroderma

64
Q

Keratin pearls on skin biopsy

A

Squamous cell carcinoma

65
Q

Antihistone antibodies

A

Drug-induced SLE

  • Hydralazine
  • Isoniazid
  • Phenytoin
  • Procainamide
66
Q

Bloody or yellow tap on lumbar puncture

A

Subarachnoid hemorrhage

67
Q

Yellowish CSF

A

Xanthochromia (eg due to subarachnoid hemorrhage)

68
Q

Eosinophilic cytoplasmic inclusion in neuron

A

Lewy body

  • Parkinson’s
  • Lewy body dementia
69
Q

Extracellular amyloid deposition in gray matter of brain

A

Senile plaques (Alzheimer’s disease)

70
Q

Depigmentation of neurons in substantia nigra

A

Parkinson disease

71
Q

Protein aggregates in neurons from hyperphosphorylation of tau protein

A
  1. Neurofibrillary tangles (Alzheimer’s disease)

2. Pick bodies (Pick disease)

72
Q

Pseudopalisading tumor cells on brain biopsy

A

Glioblastoma multiforme

73
Q

Circular grouping of dark tumor cells surrounding pale neurofibrils

A

Homer-Wright rosettes (neuroblastoma, medulloblastoma)

74
Q

Waxy casts with very low urine flow

A

Chronic end-stage renal disease

75
Q

RBC casts in urine

A

Glomerulonephritis

76
Q

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

A

Membranoproliferative glomerulonephritis

77
Q

Nodular hyaline deposits in glomeruli

A

Kimmelstiel-Wilson nodules (diabetic nephropathy)

78
Q

Podocyte fusion or effacement on electron microscopy

A

Minimal change disease (child with nephrotic syndrome)

79
Q

Spikes on BM, dome-like subepithelial deposits

A

Membranous nephropathy (nephrotic syndrome)

80
Q

Anti-glomerular BM antibodies

A

Goodpasture syndrome (glomerulonephritis and hemoptysis)

81
Q

Cellular crescents in Bowman’s capsule

A

Rapidly progressive crescentic glomerulonephritis

82
Q

Wire loop glomerular capillary appearance on light microscopy

A

Diffuse proliferative glomerulonephritis (usually seen with lupus)

83
Q

Linear appearance of IgG deposition on glomerular and alveolar BMs

A

Goodpasture syndrome

84
Q

Lumpy bumpy appearance of glomeruli on immunofluorescence

A

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

85
Q

Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis

A
  1. Granulomatosis with polyangiitis

2. Goodpasture syndrome

86
Q

Thyroid-like appearance of kidney

A

Chronic pyelonephritis (usually due to recurrent infections)

87
Q

WBC casts in urine

A

Acute pyelonephritis

88
Q

Renal epithelial casts in urine

A

Intrinsic renal failure (eg: ischemia or toxic injury)

89
Q

hCG elevated

A
  1. Choriocarcinoma

2. Hyditaform mole

90
Q

Dysplastic squamous cervical cells with raisinoid nuclei and hyperchromasia

A

Koilocytes (HPV: predisposes to cervical cancer)

91
Q

Psammoma bodies

A
  1. Meningiomas
  2. Papillary thyroid carcinoma
  3. Mesothelioma
  4. Papillary serous carcinoma of endometrium and ovary
92
Q

Disarrayed granulosa cells arranged around collections of eosinophilic fluid

A

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

93
Q

Chocolate cyst of ovary

A

Endometriosis

94
Q

Mammary gland (blue-domed) cyst

A

Fibrocystic change of breast

95
Q

Glomerulus-like structure surrounding vessel in germ cells

A

Schiller-Duval bodies (yolk sac tumor)

96
Q

Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells

A

Reinke crystals (Leydig cell tumor)

97
Q

Thrombi made of white/red layers

A

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

98
Q

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

A

Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)

99
Q

Desquamated epithelium casts in sputum

A

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

100
Q

Honeycomb lung on x-ray or CT

A

Interstitial pulmonary fibrosis

101
Q

Desquamated epithelium casts in sputum

A

Curschmann spirals (bronchial asthma, can result in whorled mucuous plugs)

102
Q

Colonies of Pseudomonas in lungs

A

CF

103
Q

Iron-containing nodules in alveolar septum

A

Ferruginous bodies (asbestosis: increased chance of lung cancer)

104
Q

Bronchogenic apical lung tumor on imaging

A

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