Classic Labs/Findings: Lab/Diagnostic Finding//Diagnosis/Disease

Question 1

Anticentromere antibodies

Answer 1

Scleroderma (CREST)

Question 2

Antihistone antibodies

Answer 2

Drug-induced SLE

hydralazine, INH, phenytoin, procainamide

Question 3

Antinuclear antibodies (ANAs: anti-Smith and anti-dsDNA)

Answer 3

SLE (type III hypersensitivity)

Question 4

Antiplatelet antibodies

Answer 4

Idiopathic thrombocytopenic purpura (ITP)

Question 5

Basophilic nuclear remnants in RBCs

Answer 5

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

Question 6

Bloody tap on LP

Answer 6

Subarachnoid hemorrhage

Question 7

Stacks of RBCs

Answer 7

Rouleaux formation (high ESR, multiple myeloma)

Question 8

Psammoma bodies

Answer 8

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

Question 9

Pseudopalisading tumor cells on brain biopsy

Answer 9

Glioblastoma multiforme

Question 10

Heterophile antibodies

Answer 10

Infectious mononucleosis (EBV)

Question 11

High level of D-dimers

Answer 11

DVT
PE
DIC

Question 12

Hypochromic, microcytic anemia

Answer 12

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

Question 13

Lytic (“hole punched”) bone lesions on x-ray

Answer 13

Multiple myeloma

Question 14

Hypersegmented neutrophils

Answer 14

Megaloblastic anemia (B12 deficiency: neurologic symptoms; folate deficiency: no neurologic symptoms)

Question 15

Needle-shaped, negatively birefringent crystals

Answer 15

Gout (monosodium urate crystals)

Question 16

Depigmentation of neurons in the substantia nigra

Answer 16

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

Question 17

Extracellular (A-beta) amyloid deposition in gray matter of brain

Answer 17

Senile plaques (Alzheimer disease)

Question 18

Giant B cells with bilobed nuclei with prominent inclusions (“owl’s eyes”)

Answer 18

Reed-Sternberg cells (Hodgkin lymphoma)

Question 19

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

Answer 19

Beta-thalassemia, sickle cell anemia (marrow expansion)

Question 20

Basophilic stippling of RBCs

Answer 20

Lead poisoning or sideroblastic anemia

Question 21

Anti-topoisomerase antibodies

Answer 21

Diffuse systemic scleroderma

Question 22

Anti-glomerular basement membrane antibodies

Answer 22

Goodpasture syndrome (glomerulonephritis and hemoptysis)

Question 23

Degeneration of dorsal column nerves

Answer 23

Tabes dorsalis (Tertiary syphilis)

(differentiated from subacute combined degeneration [B12 deficiency], where dorsal columns and lateral corticospinal tracts are affected)

Question 24

Silver-staining spherical aggregation of tau proteins in neurons

Answer 24

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

Question 25

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

Answer 25

Burkitt lymphoma (t:[8;14] c-myc activation, associated with EBV; “black sky” made up of malignant cells)