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Biochem > 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

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. 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 bactermia

A

Colon cancer

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9
Q

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

A

Ghon complex (primary 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 xray

A

Epiglottitis (hemophilus influenza)

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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 xray

A

Tetralogy of Fallot (due to RVH)

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23
Q

Rib notching (inferior surface, on x-ray)

A

Coarctation of 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

Primary hyperaldosteronism (Conn syndrome)

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27
Q

Enlarged thyroid cells with ground glass nuclei with central clearing

A

Orphan Annie eyes nuceli (papillary carcinoma of the thyroid)

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28
Q

ANCAs

A

Microscopic polyangitis and eosinophilic granulomatous with polyangitis (MPO-ANCA/p-ANCA); granulomatous with polyangitis (Wegner; PR3- ANCA/c-ANCA); primary sclerosing cholangitis (MPO-ANCA/ 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 of colonoscopy

A

FAP ( 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 of 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

A

PBC (female, cholestasis, portal hypertension)

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39
Q

Low serum ceruloplasmin

A

Wilson disease (hepatolenticular degeneration; Kayser- Fleishcer 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

IDA, lead poisoning, thalessemia (fetal hemoglobin sometimes present)

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43
Q

Basophilic stippling of RBCs

A

Lead poisoning of sideroblastic anemia

44
Q

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

A

B-thalessemia, 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 thrmobocytopenic purpura

47
Q

High level of D-dimers

A

DVT, PE, DIC

48
Q

Giant B cells with bilobed nuclei with prominent inclusion (owls eye)

A

Reed-Sternberg (Hodgkin Lymphoma)

{Enlarged cells with intranuclear inclusion bodies = owl eye appearance of CMV}

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)
  • Waldenstrom (M protein = IgM) macroglobulinemia
  • Primary amyloidosis
52
Q

Stacks of RBCs

A

Rouleaux formation (high ESR, multiple myeloma)

53
Q

Axurophilic peroxidase + granular inclusions in granulocytes and myelobasts

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

RA (Systemic inflammation, joint pannus, boutonniere and swan neck deformities)

61
Q

Rhomboid cystals, + 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 anti-dsDNA)

A

SLE (type III hypersensitivity)

66
Q

Anti-topoisomerase antibodies

A

Diffuse systemic scleroderma

67
Q

Kerain 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

70
Q

Yellowish CSF

A

Xanthochromia (eg; due to SAH)

71
Q

Eosinophilic cytoplasmic inclusion in neuron

A

Lewy body (Parkinson disease and Lewy body dementia)

72
Q

Extracellular amyoid 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 tanges (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 diseas

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

Kimmesteil- 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, C3)

89
Q

Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis

A

granulomatosis with polyangitis (Wegner; PR3- ANCA/ c-ANCA) and Goodpasture syndrome (anti-basement membrane antibodies)

90
Q

Thyroid like appearance like kidney

A

Chronic pyelonephritis (usually due to recurrent infections)

91
Q

WBC casts in urine

A

Acute pyelonephritis

92
Q

hCG elevated

A

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

93
Q

Dysplastic squamous cervical cells with rasinoid nuclei and hyperchromasia

A

Koilocytes (HPV: predisposes to cervical cancer)

94
Q

Psammoma bodies

A

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

95
Q

Disarrayed granulosa cells arranged around collections of eosinophilic fluid

A

Call exner bodies (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 crustals 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 xray or CT

A

Interstitial pulmonary fibrosis

104
Q

Colonies of mucoud Pseudomonas in lungs

A

Cystic fibrosis (autosomal recessive mutation in CFTR gene= fat-soluble vitamin deficiency and mucous plugs)

105
Q

Iron-containing nodules in alveolar sputums

A

Ferruginous bodies (asbestosis: increased change of lung cancer

106
Q

Bronchogenic apical lung tumor on imaging

A

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

Biochem (9 decks)

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