Classic Labs/Findings IV

Question 1

“Soap bubble” in femur or tibia on x-ray

Answer 1

Giant cell tumor of bone (generally benign)

Question 2

“Spikes” on basement membrane, “dome-like” subepithelial deposits

Answer 2

Membranous nephropathy (nephrotic syndrome)

Question 3

Stacks of RBCs

Answer 3

Rouleaux formation (High ESR, multiple myeloma)

Question 4

Steeple sign on CXR

Answer 4

Croup (parainfluenza virus)

Question 5

Stippled vaginal epithelial cells

Answer 5

“Clue cells” (Gardnerella aginalis)

Question 6

Streptococcus bovis bacteremia

Answer 6

Colon cancer

Question 7

“Tennis racket” shaped cytoplasmic organelles (EM) in Langerhans cells

Answer 7

Birbeck granules (Langerhans cell hystiocytosis)

Question 8

Thousands of polyps on coonoscopy

Answer 8

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

Question 9

Thrombi made of white/red layers

Answer 9

Lines of Zahn (arterial thrombus, layers of platelets/RBC’s)

Question 10

“Thumb sign” on lateral neck x-ray

Answer 10

Epiglottitis (Haemophilus influenzae)

Question 11

Thyroid-like appearance of kidney

Answer 11

Chronic pyelonephritis (Usually due to recurrent infections)

Question 12

“Tram-track” appearance of capillary loops of glomerular basement membranes on light microscope

Answer 12

Membranoproliferative glomerulonephritis

Question 13

Triglyceride accumulation in liver cell vacuoles

Answer 13

Fatty liver disease (alcoholic or metabolic syndrome)

Question 14

Waxy casts with very low urine flow

Answer 14

Chronic end-stage renal disease

Question 15

WBC casts in urine

Answer 15

Acute pyelonephritis

Question 16

WBC’s that look “smudged”

Answer 16

CLL (almost alway sB cell)

Question 17

“Wire loop” glomerular capillary appearance on light microscopy

Answer 17

Diffuse proliferative glomerulonephritis (usually seen with lupus)

Question 18

Yellowish CSF

Answer 18

Xanthochromia (e.g., due to subarachnoid hemorrhage)