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Rapid Review > Classic Labs/findings > Flashcards

Classic Labs/findings Flashcards

1
Q

Down syndrome, Edward syndrome

A

LOW AFP in amniotic fluid/maternal serum

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2
Q

Chediak Higashi disease (congenital failure of phagolysosome formation)

A

Large granules in phagocytes

Immunodeficiency

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3
Q

Wiskott Aldrich syndrome

A

Recurrent infections
Eczema
Thrombocytopenia

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4
Q

Optochin sensitive

A

Streptococcus pneumoniae

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5
Q

Optichin RESISTANT

A

Viridans streptococci

  1. S mutans
  2. S sanguis
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6
Q

Novobiocin sensitive

A

Staphylococcus epidermidis

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7
Q

Novobiocin resistant

A

Staphylococcus saprophyticus

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8
Q

Bacitracin sensitive

A

Streptococcus pyogenes (group A)

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9
Q

Bacitracin resistant

A

Streptococcus agalactiae (group B)

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10
Q

Colon cancer

A

Streptococcus bovis bacteremia

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11
Q

Actinomyces israelii

A

Branching gram + rods with sulfur granules

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12
Q

Ghon complex (primary TB Mycobacterium bacilli)

A

Hilar lymphadenopathy AND Peripheral granulomatous lesion in middle or lower lung lobes (can calcify)

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13
Q

Epiglottitis (Haemophilus influenzae)

A

“Thumb sign” on lateral neck XR

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14
Q

Clue cells (Gardnerella vaginalis)

A

Bacteria covered vagina epithelial cells

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15
Q

Chagas’ disease (Trypanosoma cruzi)

A

Dilated cardiomyopathy with apical atrophy
MEGACOLON
MEGAESOPHAGUS
South America
Romana sign- unilateral periorbital swelling

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16
Q

Epstein Barr Virus

A

Atypical lymphocytes

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17
Q

“Owl eye” appearance of CMV

A

Enlarged cells with intranuclear inclusion bodies

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18
Q

Infectious mononucleosis (EBV)

A

Heterophile antibodies

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19
Q

Cowdry Type A bodies (HSV or VZV)

A

Intranuclear eosinophilic droplet like bodies

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20
Q

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

A

Eosinophilic globule in liver

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21
Q

Croup (parainfluenza virus)

A

“Steeple sign” on frontal CXR

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22
Q

Negri bodies of rabies

A

Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar neurons

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23
Q

Toxoplasma gondii, CNS lymphoma

A

Ring enhancing bran lesion on CT/MRI in AIDS

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24
Q

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

A

Psamomma bodies

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25
Q

Wolff Parkinson White syndrome (bundle of Kent bypasses AV node)

A

“Delta wave” on EKG, short PR interval, supraventricular tachycardia

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26
Q

Tetralogy of Fallot (d/t RVH)

A

“Boot shaped” heart on CXR

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27
Q

Coarctation of the aorta

A

Rib notching (inferior surface on XR)

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28
Q

Aschoff bodies (rheumatic fever)

A

Heart nodules (granulomatous)

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29
Q

Cardiac tamponade

A

Electrical alternans (alternating amplitude on EKG)

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30
Q
  1. Microscopic polyangiitis and eosinophilic granulomatosis with polyangiitis (MPO-ANCA/p-ANCA)
  2. Granulomatosis with polyangiitis (Wegener; PR3 ANCA/c-ANCA
  3. Primary sclerosing cholangitis (MPO-ANCA/p-ANCA)
A

Antineutrophil cyroplasmic antibodies (ANCAs)

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31
Q

Primary hyperaldosteronism (Conn syndrome)

A

HTN
Hypokalemia
Metabolic alkalosis

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32
Q

“Orphan Annie” eyes nuclei (papillary carcinoma of thyroid)

A

Enlarged thyroid cells with ground glass nuclei with central clearing

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33
Q

Signet ring (diffuse gastric carcinoma)

A

Mucin filled cell with peripheral nucleus

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34
Q

Celiac disease (diarrhea, weight loss)

A

Anti transglutaminase/anti gliadin/anti endomysial antibodies

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35
Q

String sign (Crohn disease)

A

Narrowing of bowel lumen barium x Ray

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36
Q

Ulcerative colitis (loss of haustra)

A

Lead pipe appearance of colon on abdominal imaging

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37
Q

Familial adenomatous polyposis (autosomal dominant, mutation of APC gene)

A

Thousands of polyps on colonoscopy

100% progression to colon cancer

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38
Q

Colorectal cancer (usually left sided)

A

“Apple core” lesion on barium enema

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39
Q

Mallory body (alcoholic liver disease)

A

Eosinophilic cytoplasmic inclusions of damaged keratin filaments in liver cell

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40
Q

Fatty liver disease (alcoholic or metabolic syndrome)

A

Triglyceride accumulation in liver cell vacuoles

Cellular “ballooning”

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41
Q

Chronic passive congestion of liver d/t RHF or Budd Chiari syndrome

A

Nutmeg appearance of liver

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42
Q

Primary biliary cholangitis (female, cholestasis, portal HTN)

A

Anti mitochondrial antibodies(AMAs)

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43
Q

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

A

Low ceruloplasmin

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44
Q

Trousseau syndrome (adenocarcinoma of pancreas or lung)

A

Migratory thrombophlebitis (leading to migrating DVTs and vasculitis)

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45
Q

Howell Jolly bodies (due to splenectomy or non functional spleen)

A

Basophilic nuclear remnants in RBCs

46
Q

Lead poisoning or sideroblastic anemia

A

Basophilic stippling of RBCs

47
Q

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

A

Hypochromic, microcytic anemia

48
Q

Beta thalassemia, sickle cell disease (bone marrow expansion)

A

Hair on end, crew cut appearance on x Ray

49
Q

Megaloblastic anemia (B12 deficiency: neurological symptoms, folate deficiency: no neuro symptoms)

A

Hypersegmented neutrophils

50
Q

Idiopathic thrombocytopenia purpura

A

Anti platelet antibodies

51
Q

DVT, PE, DIC

A

High level of D dimers

52
Q

Reed Sternberg cells (Hodgkin lymphoma)

A

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

53
Q

Burkitt lymphoma (t[8:14], c myc activation, ASSOC W EBV: “starry sky” made up of malignant cells”

A

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

54
Q

Multiple myeloma

A

Lytic “punched out” bone lesions on x Ray

55
Q
  1. Multiple myeloma (usually IgG or IgA)
  2. Monoclonal gammopathy of undetermined significance (MGUS consequence of aging)
  3. Walden storm (M protein = IgM) macroglobulinemia
  4. Primary amyloidosis
A

Monoclonal antibody spike

56
Q

Rouleaux formation (high ESR, multiple myeloma)

A

Stacks of RBCs

57
Q

Auer rods (AML, esp promyelocytic M3 type)

A

Azurophilic peroxidase + granular inclusions in granulocytes and myeloblasts

58
Q

CLL (almost always B cell)

A

WBCs that look “smudged”

Crushed Little Lymphocytes

59
Q

Birbeck granules (Langerhans histiocytosis)

A

Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells

60
Q

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

A

“Brown” tumor of bone

61
Q

Giant cell tumor of bone (usually benign)

A

“Soap bubble” in femur or tibia on x Ray

62
Q

Aggressive bone lesion (osteosarcoma, Ewing sarcoma, osteomyelitis)

A

Raised periosteum (creating Codman’s triangle)

63
Q

Ewing sarcoma (malignant small blue cell tumor)

A

Onion skin periosteal reaction

64
Q

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

A

HLA DR4
+ rheumatoid factor (IgM antibody that targets IgG Fc region), anti IgG
+ anti cyclic citrullinated peptide (anti CCP)- more specific

65
Q

Pseudogout (calcium pyrophosphate dihydrate crystals)

A

Rhomboid crystals, + birefringement

66
Q

Gout (monosodium urate crystals)

A

Needle shaped

- birefringement crystals

67
Q

Gout
Lesch Nyhan syndrome
Tumor lysis syndrome
Loop and thiazides diuretics

A

High uric acid levels

68
Q

Ankylosing spondylitis (chronic inflammatory arthritis, HLA B27)

A

Bamboo spine on x Ray

69
Q

SLE (type III HSR)

A

Anti nuclear antibodies (ANAs: anti Smith and anti dsDNA)

70
Q

Drug induced SLE (hydralazine, INH, procainamide, phenytoin)

A

Anti histone antibodies

71
Q

Diffuse scleroderma

A

Anti topoisomerase antibodies

72
Q

Squamous cell carcinoma (skin bx)

A

Keratin pearls on skin bx

73
Q

Xanthochromia (due to subarachnoid hemorrhage)

A

Bloody or yellow tap on lumbar puncture

74
Q

Lewy body (Parkinson disease and Lewy body dementia)

A

Eosinophilic cytoplasmic inclusion in neuron

75
Q

Senile plaques (Alzheimer’s disease)

A

Extra cellular amyloid deposition in grey matter

76
Q

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

A

Depigmentation of neurons in substantial nigra

77
Q

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

A

Protein aggregates in neurons from hyperphosphorylation of TAU protein

78
Q

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

A

Silver staining spherical aggregation of tau proteins in neurons

79
Q

Glioblastoma multiforme

A

Pseudopalisading tumor cells on brain biopsy

80
Q

Homer Wright rosettes (neuroblastoma, medullablastoma)

A

Circulating grouping of dark tumor cells surrounding pale neurofibrils

81
Q

Chronic end stage renal disease

A

WAXY CASTSwith very low urine flow

82
Q

Kimmelstein Wilson nodules (diabetic nephropathy)

A

Nodular hyaline deposits in glomeruli

83
Q

Minimal change disease (child with nephrotic syndrome)

A

Podocyte fusion or “effacement” on electron microscopy

84
Q

Membranous nephropathy (nephrotic syndrome)

A

“SPIKES” on basement membrane, “DOME LIKE” subepithelial deposits

85
Q

Glomerulonephritis

A

RBC casts in urine

86
Q

Membranoproliferative glomerulonephritis

A

TRAM TRACK appearance of capillary loops of gomerular basement membranes on LM

87
Q

Goodpasture syndrome (glomerulonephritis AND hemoptysis)

A

Anti glomerular basement membrane antibodies

88
Q

Rapidly progressive (crescentic) glomerulonephritis

A

Cellular crescents in Bowman capsule

89
Q

Diffuse proliferative glomerulonephritis (usually seen with lupus)

A

WIRE LOOP glomerular capillary appearance on LM

90
Q

Goodpasture syndrome

A

LINEAR appearance of IgG deposition on glomerular AND alveolar basement membranes

91
Q

Poststreptococcal glomerulanephritis (dt deposition of IgG, IgM, C3)

A

LUMPY BUMPY appearance of glomeruli on immunofluorescence

92
Q

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

A

Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis

93
Q

Chronic pyelonephritis (dt recurrent infections)

A

Thyroid like appearance of kidney

94
Q

Acute pyelonephritis

A

WBC casts in urine

95
Q

Intrinsic renal failure (ischemia, toxic injury)

A

Renal epithelial casts in urine

96
Q 
Choriocarcinoma
Hydatiform mole (occurs with and without embryo, and multiple pregnancy)
A

hCG elevated

97
Q

Koilocytes (HPV: predisposes to cervical cancer)

A

Dysplastic squamous cervical cells with “raisonoid” nuclei and hyperchromasia

98
Q

Call Exner bodies (granulosa cell tumor from ovary)

A

Disarrayed granulosa cells arranged around collections of eosinophilic fluid

99
Q

Endometriosis (involves both ovaries)

A

“Chocolate cyst” of ovary

100
Q

Fibrocystic changes of breast

A

Mammary gland (blue domed) cyst

101
Q

Schiller Duval bodies (yolk sac tumor)

A

Glomerulus like structure surrounding vessel in germ cells

102
Q

Reinke crystals (Leydig cell tumor)

A

Rectangular crystal like cytoplasmic inclusions in Leydig cells

103
Q

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

A

Thrombi made of red and white layers

104
Q

Bronchial asthma (Charcot Leyden crystals: eosinophilic granules)

A

Hexagonal double pointed needle like crystals in bronchial secretions

105
Q

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

A

Desquamated epithelium casts in sputum

106
Q

Idiopathic pulmonary fibrosis

A

Honey comb lung on CXR/CT

107
Q

Cystic fibrosis (AR mutation in CFTR gene-> fat soluble vitamin deficiency and mucus plugs)

A

Colonies of mucous Pseudomonas in lungs

108
Q

Ferruginous bodies (asbestos; HIGH chance of lung cancer)

A

Iron containing nodules in alveolar sputum

109
Q

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

A

Bronchiogenic apical lung tumor on imaging

110
Q

Aldosterone MOA

A

Inserts Na channels and Nak ATPase in principal cell in collecting duct

More Na pulled back into interstitium and more K goes out in urine

Printed insertion of H pumps into intercalated cells, promote H excretion into urine

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