Classic Labs/Findings Flashcards
antidesmoglein (epithelial) Ab
pemphigus vulgaris (blistering)
Anticentromere Ab
scleroderma (CREST)
anti-glomerular BM Ab
Goodpasture’s syndrome (GN & hemoptysis)
antihistone Ab
drug induced lupus (hydralazine, INH, phenytoin, procainamide)
Anti-IgG Ab
Rheumatoid arthritis (systemic inflam, joint pannus, boutonniere deformity)
antimitochondrial Ab
primary biliary cirrhosis (female, cholestasis, portal HTN)
antineutrophil cytoplasmic Ab (ANCA)
vasculitis (C-ANCA granulomatosis w/polyangiitis/Wegeners; p-ANCA microscopic polyangiitis, Churg-strauss)
antinuclear antibodies (ANAs: anti-Smith, and anti-dsDNA)
SLE (type III HS)
antiplatelet Ab
idiopathic thrombocytopenic purpura
anti-topoisomerase ab
diffuse systemic scleroderma
anti-transglutaminase/anti-gliadin/anti-endomysial Ab
celiac dz (diarrhea, distension, weight loss)
“apple core” lesion on abdominal XRAY
CRC (usually left side)
azurophilic peroxidase positive granular inclusions in granulocytes and myeloblasts
Auer rods (AML, esp the promyelocytic M3 type)
bacitracin response
sensitive: Strep pyogenes (grp A); resistant: Strep agalactiae (grp B)
“bamboo spine” on xray
ankylosing spondylitis (chronic inflam arthritis: HLA-B27)
basophilic nuclear remnants in RBCs
Howell-Jolly bodies (due to splenectomy or nonfunctional spleen)
basophilic stippling of RBCs
lead poisoning or sideroblastic anemia
bloody tap on LP
subarachnoid hemmorhage
“boot shaped” heart on xray
tetralogy of fallot, RVH
branching gram positive rods with sulfur granules
Actinomyces israelii
bronchogenic apical lung tumor on imaging
Pancoast tumor (can compress sympathetic ganglion and cause Horner’s syndrome)
“Brown” tumor of bone
hyperparathyroidism or osteitis fibrosa cystica (deposited hemosiderin from hemorrhage gives brown color)
cardiomegaly with apical atrophy
Chagas’ dz (Trypanasoma cruzi)
cellular crescents in Bowman’s capsule
rapidly progressive crescentic GN
“chocolate cyst” of ovary
endometriosis (frequently involves both ovaries)
circular grouping of dark tumor cells surrounding pale neurofibrils
Homer-Wright rosettes (neuroblastoma, medulloblastoma, retinoblastoma)
colonies of mucoid Pseudomonas in lungs
Cystic fibrosis (AR mutation in CFTR resulting in fat soluble vitamin deficiency and mucous plugs)
decreased alpha fetoprotein in amniotic fluid/maternal serum
Down syndrome or other chromosomal abnormality
degeneration of dorsal column nerves
Tabes dorsalis (tertiary syphilis), B12 def- subacute combined degeneration (dorsal columns and lateral corticospinal tracts affected)
depigmentation of neurons in substantia nigra
Parkinson’s dz (basal ganglia disorder: rigidity, resting tremor, bradykinesia)
desquamated epithelium casts in sputum
Curschmann’s spirals (bronchial asthma; can result in whorled mucus plugs)
disarrayed granulosa cells in eosinophilic fluid
Call-Exner bodies (granulosa-theca cell tumor of the ovary)
dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia
Koilocytes (HPV: predisposes to cervical cancer)
enlarged cells with intranuclear inclusion bodies
“owl’s eye” appearance of CMV
enlarged thyroid cells with ground-glass nuclei
“orphan annie’s eyes” nuclei (papillary carcinoma of the thyroid)
eosinophilic cytoplasmic inclusion in liver cell
Mallory bodies (alcoholic liver dz)
eosinophilic cytoplasmic inclusion in nerve cell
Lewy body (Parkinson’s dz)
eosinophilic globule in liver
Councilman body (toxic or viral hepatitis, often yellow fever)
eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells
negri bodies of rabies (Lyssavirus)
extracellular amyloid deposition in gray matter of brain
senile plaques (Alzheimer’s dz)
Giant B cells w/bilobed nuclei w/prominent inclusions (“owl’s eye”)
Reed-Sternberg cells (Hodgkin’s lymphoma)
glomerulus-like structure surrounding vessel in germ cells
Schiller-Duval bodies (yolk sac tumor)
“hair on end” (crew-cut) appearance on xray
B-thalassemia, sickle cell anemia (marrow expansion)
hCG elevated
choriocarcinoma, hydatidiform mole (occurs with and without embryo)
heart nodules (granulomatous)
Aschoff bodies (RF)
heterophile Ab
infectious mononucleosis (EBV)
hexagonal, double-pointed, needle-like crystals in bronchial secretions
Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)
high level of D-dimers
DVT, PE, DIC
hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Ghon complex (primary TB: Mycobacterium bacilli)
“honeycomb lung” on xray or CT
interstitial pulmonary fibrosis
hypercoagulability (leading to migrating DVTs and vasculitis)
Trousseau’s syndrome (adenocarcinoma of pancreas or lung)
hypersegmented PMNs
megaloblastic anemia (B12 def: neurologic sx, folate def: no neuro sx)
HTN, hypokalemia, metab alk
Conn’s syndrome
Hypochromic, microcytic anemia
Iron def anemia, lead poisoning, thalassemia (fetal HgB sometimes present)
increased alpha fetoprotein in amniotic fluid/maternal serum
dating error, anencephaly, spina bifida (neural tube defects)
increased uric acid levels
gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics
intranuclear eosinophilic droplet-like bodies
Cowdry type A bodies (HSV or CMV)
Fe-containing nodules in alveolar septum
Ferruginous bodies (asbestosis: inc chance of mesothelioma)
keratin pearls on a skin biopsy
SCC
large lysosomal vesicles in phagocytes, immunodeficiency
Chediak-Higashi dz (congenital failure of phagolysosome formation)
“lead pipe” appearance of colon on barium enema xray
ulcerative colitis (loss of haustra)
linear appearance of IgG deposition on glomerular BM
Goodpasture’s syndrome
low serum ceruloplasmin
Wilson’s dz (hepatolenticular degeneration)
“lumpy bumpy” appearance of glomeruli on IF
poststreptococcal GN (immune complex deposition of IgG and C3b)
lytic (“hole-punched”) bone lesions on x-ray
multiple myeloma
mammary gland (“blue domed”) cyst
fibrocystic change of the breast
monoclonal Ab spike
- multiple myeloma (usually IgG or IgA)
- monoclonal gammopathy of undetermined significance (MGUS; normal consequence of aging)
- Waldenstrom’s (M protein = IgM) macroglobulinemia
- primary amyloidosis
mucin-filled cell with peripheral nucleus
signet ring (gastric carcinoma)
narrowing of bowel lumen on barium xray
“string sign” (Crohn’s dz)
necrotizing vasculitis (lungs) and necrotizing GN
granulomatosis w/polyangiitis (Wegener’s; c-ANCA positive) and Goodpasture’s syndrome (anti-BM Ab)
needle-shaped, negatively birefringent crystals
gout (monosodium urate crystals)
nodular hyaline deposits in glomeruli
Kimmelstiel-Wilson nodules (diabetic nephropathy)
novobiocin response
sensitive: Staph epidermidis; resistant: staph saprophyticus
“nutmeg” appearance of liver
chronic passive congestion of liver due to RHF
“onion skin” periosteal rxn
Ewing’s sarcoma (malignant round-cell tumor)
optochin response
sensitive: strep pneumo; resistant: viridans
periosteum raised from bone, creating triangular area
codman’s triangle on xray (osteosarcoma, Ewing’s sarcoma, pyogenic osteomyelitis)
podocyte fusion or “effacement” on EM
minimal change dz (child w/nephrotic synd)
polished, “ivory like” appearance of bone at cartilage erosion
eburnation (osteoarthritis resulting in bony sclerosis)
protein aggregates in neurons from hyperphosphorylation of protein tau
neurofibrillary tangles (Alzheimer’s dz) and Pick’s bodies (Pick’s dz)
psammoma bodies
meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of the endometrium and ovary
pseudopalisading tumor cells on brain bx
glioblastoma multiforme
RBC casts in urine
acute GN
rectangular, crystal-like cytoplasmic inclusions in Leydig cells
Reinke crystals (Leydig cell tumor)
renal epithelial casts in urine
acute toxic/viral nephrosis
rhomboid crystals, positively birefringent
pseudogout (calcium pyrophosphate dihydrate crystals)
rib notching
coarctation of the aorta
ring-enhancing brain lesion in AIDS
toxoplasma gondii, CNS lymphoma
sheets of medium-sized lymphoid cells w/scattered pale, tingible body-laden macrophages (“starry sky” histology)
Burkitt’s lymphoma (t[8;14] c-myc activation, a/w EBV; “black sky” made up of malignant cells)
silver-staining spherical aggregation of tau proteins in neurons
Pick bodies (Pick’s dz: progressive dementia, changes in personality)
“soap bubble” in femur or tibia on xray
giant cell tumor of bone (generally benign)
“spikes” on BM, “dome like” subepithelial deposits
membranous GN (may progress to nephrotic syndrome)
stacks of RBCs
rouleaux formation (high ESR, multiple myeloma)
stippled vaginal epithelial cells
“clue cells” (gardnerella vaginalis)
“tennis racket” shaped cytoplasmic organelles (EM) in Langerhan’s cells
birbeck granules (Langerhans cell histiocytosis or histiocytosis X: eosinophilic granuloma)
thrombi made of white/red layers
lines of Zahn (arterial thrombus, layers of platelets/RBCs)
“thumb sign” on lateral xray
epiglottitis (H. flu)
thyroid-like appearance of kidney
chronic bacterial pyelonephritis
tram-track appearance of capillary loops of glomerular BM on LM
membranoproliferative GN
triglyceride accumulation in liver cell vacuoles
fatty liver dz (alcoholic or metab syndrome)
“waxy” casts w/very low urine flow
chronic end-stage renal dz
WBC casts in urine
acute pyelonephritis
WBCs that look “smudged”
CLL (almost always B cell)
“wire loop” glomerular capillary appearance on LM
lupus nephropathy
yellowish CSF
xanthochromia (eg due to subarachnoid hemorrhage)
