FA - Classic Labs/Findings Flashcards
Anticentromere antibodies
Scleroderma (CREST)
Antidesmoglein (epithelial) antibodies
Pemphigus vulgaris (blistering)
Anti–glomerular basement membrane antibodies
Goodpasture syndrome (glomerulonephritis and hemoptysis)
Antihistone antibodies
Drug-induced SLE (hydralazine, INH, phenytoin, procainamide)
Anti-IgG antibodies
Rheumatoid arthritis (systemic inflammation, joint pannus, boutonnière deformity)
Antimitochondrial antibodies (AMAs)
1° biliary cirrhosis (female, cholestasis, portal hypertension)
Antineutrophil cytoplasmic antibodies (ANCAs)
Microscopic polyangiitis and Churg-Strauss syndrome (MPO-ANCA/p-ANCA)
granulomatosis with polyangiitis (Wegener; PR3-ANCA/c-ANCA)
Antinuclear antibodies (ANAs: anti-Smith and anti-dsDNA)
SLE (type III hypersensitivity)
Antiplatelet antibodies
Idiopathic thrombocytopenic purpura
Anti-topoisomerase antibodies
Diffuse systemic scleroderma
Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies
Celiac disease (diarrhea, distention, weight loss)
“Apple core” lesion on abdominal x-ray
Colorectal cancer (usually left-sided)
Azurophilic peroxidase
Auer rods (AML, especially the promyelocytic [M3] type)
Bacitracin response
Sensitive: Streptococcus pyogenes (group A)
Resistant: Streptococcus agalactiae (group B)
“Bamboo spine” on x-ray
Ankylosing spondylitis (chronic inflammatory 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 hemorrhage
“Boot-shaped” heart on x-ray
Tetralogy of Fallot, RVH
Branching gram-positive rods with yellow sulfur granules
Actinomyces israelii
Bronchogenic apical lung tumor on imaging
Pancoast tumor (can compress sympathetic ganglion and cause Horner syndrome)
“Brown” tumor of bone
Hyperparathyroidism or osteitis fibrosa cystica (deposited hemosiderin from hemorrhage gives brown color)
Cardiomegaly with apical atrophy
Chagas disease (Trypanosoma cruzi)
Cellular crescents in Bowman capsule
Rapidly progressive crescentic glomerulonephritis
“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 (autosomal recessive mutation in CFTR gene -> fat-soluble vitamin deficiency and mucous plugs)
decr. AFP in amniotic fluid/maternal serum
Down syndrome or other chromosomal abnormality
Degeneration of dorsal column nerves
Tabes dorsalis (3° syphilis), subacute combined degeneration (dorsal columns and lateral corticospinal tracts affected)
Depigmentation of neurons in substantia nigra
Parkinson disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia)
Desquamated epithelium casts in sputum
Curschmann spirals (bronchial asthma; can result in whorled mucous 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 eye” appearance of CMV
Enlarged thyroid cells with ground-glass nuclei
“Orphan Annie” eyes nuclei (papillary carcinoma of the thyroid)
Eosinophilic cytoplasmic inclusion in liver cell
Mallory body (alcoholic liver disease)
Eosinophilic cytoplasmic inclusion in nerve cell
Lewy body (Parkinson disease)
Eosinophilic globule in liver
Councilman body (toxic or viral hepatitis, often yellow fever)
Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar nerve cells
Negri bodies of rabies
Extracellular amyloid deposition in gray matter of brain
Senile plaques (Alzheimer disease)
Giant B cells with bilobed nuclei with prominent inclusions (“owl’s eye”)
Reed-Sternberg cells (Hodgkin lymphoma)
Glomerulus-like structure surrounding vessel in germ cells
Schiller-Duval bodies (yolk sac tumor)
“Hair on end” (crew-cut) appearance on x-ray
β-thalassemia
sickle cell anemia (marrow expansion)
hCG elevated
Choriocarcinoma hydatidiform mole (occurs with and without embryo, and multiple pregnancy)
Heart nodules (granulomatous)
Aschoff bodies (granuloma w/ giant cells, associated with rheumatic fever)
Heterophile antibodies
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 (1° TB: Mycobacterium bacilli)
“Honeycomb lung” on x-ray or CT
Interstitial pulmonary fibrosis
Hypercoagulability (leading to migrating DVTs and vasculitis)
Trousseau syndrome (adenocarcinoma of pancreas or lung)
Hypersegmented neutrophils
Megaloblastic anemia (B12 deficiency: neurologic symptoms; folate deficiency: no neurologic symptoms)
Hypertension, hypokalemia, metabolic alkalosis
Conn syndrome
Hypochromic, microcytic anemia
Iron deficiency anemia, lead poisoning, thalassemia (fetal hemoglobin sometimes present)
Increased AFP 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)
Iron-containing nodules in alveolar septum
Ferruginous bodies (asbestosis: incr. chance of mesothelioma)
Keratin pearls on a skin biopsy
Squamous cell carcinoma
Large lysosomal vesicles in phagocytes, immunodeficiency
Chédiak-Higashi disease (congenital failure of phagolysosome formation)
“Lead pipe” appearance of colon on barium enema x-ray
Ulcerative colitis (loss of haustra)
Linear appearance of IgG deposition on glomerular basement membrane
Goodpasture syndrome
Low serum ceruloplasmin
Wilson disease (hepatolenticular degeneration)
“Lumpy bumpy” appearance of glomeruli on immunofluorescence
Poststreptococcal glomerulonephritis (immune complex
Lytic (“hole punched”) bone lesions on x-ray
Multiple myeloma
Mammary gland (“blue domed”) cyst
Fibrocystic change of the breast
Monoclonal antibody spike
Multiple myeloma (usually IgG or IgA)
Monoclonal gammopathy of undetermined significance
(MGUS consequence of aging)
Waldenström (M protein = IgM) macroglobulinemia
Primary amyloidosis
Mucin-filled cell with peripheral nucleus
“Signet ring” (gastric carcinoma)
Narrowing of bowel lumen on barium x-ray
“String sign” (Crohn disease)
Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis
Granulomatosis with polyangiitis (Wegener; PR3-ANCA/c-ANCA) and Goodpasture syndrome (anti–basement
membrane antibodies)
Needle-shaped, negatively birefringent crystals
Gout (monosodium urate crystals)
Nodular hyaline deposits in glomeruli
Kimmelstiel-Wilson nodules (diabetic nephropathy)
Novobiocin response
Sensitive: Staphylococcus epidermidis; resistant: Staphylococcus saprophyticus
hemolysis, uremia, and thrombocytopenia
EHEC triad
“Nutmeg” appearance of liver
Chronic passive congestion of liver due to right heart failure
Elementary body vs reticulate body
chlamydia
elementary = extracellular, “enfectious”, enters cells via endocytosis
reticulate body = “replicative state”
Optochin response
Sensitive: Streptococcus pneumoniae
resistant: viridans streptococci
Periosteum raised from bone, creating triangular area
Codman triangle on x-ray (osteosarcoma, Ewing sarcoma, pyogenic osteomyelitis)
Podocyte fusion or “effacement” on electron microscopy
Minimal change disease (child with nephrotic syndrome)
Polished, “ivory-like” appearance of bone at cartilage erosion
Eburnation (osteoarthritis resulting in bony sclerosis)
Protein aggregates in neurons from hyperphosphorylation of tau protein
Neurofibrillary tangles (Alzheimer disease)
Pick bodies (Pick disease)
Psammoma bodies
MPMP Meningiomas Papillary thyroid carcinoma Mesothelioma Papillary serous carcinoma of the endometrium and ovary
Pseudopalisading tumor cells on brain biopsy
Glioblastoma multiforme
RBC casts in urine
Acute glomerulonephritis
Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells
Reinke crystals (Leydig cell tumor)
Renal epithelial casts in urine
Acute toxic/viral renal injury
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 with scattered pale, tingible body–laden macrophages (“starry sky” histology)
Burkitt lymphoma (t[8:14] c-myc activation, associated with EBV; “black sky” made up of malignant cells)
Silver-staining spherical aggregation of tau proteins in neurons
Pick bodies (Pick disease: progressive dementia, changes in personality)
“Soap bubble” in femur or tibia on x-ray
Giant cell tumor of bone (generally benign)
“Spikes” on basement membrane, “dome-like” subepithelial deposits
Membranous glomerulonephritis (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 Langerhans 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 x-ray
Epiglottitis (Haemophilus influenzae)
Thyroid-like appearance of kidney
Chronic bacterial pyelonephritis
“Tram-track” appearance of capillary loops of glomerular basement membranes on light microscopy
Membranoproliferative glomerulonephritis
Triglyceride accumulation in liver cell vacuoles
Fatty liver disease (alcoholic or metabolic syndrome)
“Waxy” casts with very low urine flow
Chronic end-stage renal disease
WBC casts in urine
Acute pyelonephritis
WBCs that look “smudged”
CLL (almost always B cell)
“Wire loop” glomerular capillary appearance on light microscopy
Lupus nephropathy
Yellowish CSF
Xanthochromia (e.g., due to subarachnoid hemorrhage)
CEA
colon
CA19
pancreatic cancer - 19 is when andrew s. started drinking
CA125
ovarian cancer
calcitonin
MTC
PTHrP
lung SCC - squamous
lung small cell paraneoplastic factors
ACTH, ADH, Lambert Eaton Syndrome
koilocytes
HPV
guarineri bodies
small pox
negri
rabies
synctia
measles
owls eyes
cmv (reed sternberg also have similar looking things)
schuffner dots in RBC
plasmodium vivax or ovale
Downey Cells
EBV
Holly Jewell
hyposplenia or asplenia (basophiilic nuclear remnants in RBC; normally removed by splenic macrophages)
Heinz bodies
G6PD
Coffee-bean nuclei
brenner tumor
ovarian neoplasm with spindle shaped fibroblasts
fibroma
ovarian neoplasm with Call-Exner bodies
Granulosa cell tumor
ovarian neoplasm with fried egg appearance
dysgerminoma; tumor marker hCG, LDH
ovarian neoplasm with Psammoma bodies
Serous Cystadenocarcinoma
ovarian neoplasm with increased hCG and LDH
dysgerminoma
ovarian neoplasm with Schiller-Duval bodies with increased AFP
Yolk Sac tumor
Signet cells in ovaries
Krukenberg tumor - GI metz
microcalcifications on mammography
ductal carcinoma in situ (DCIS) - malignant breast tumor
orderly row of cells in breast biopsy
invasive lobular “indian file”
testicular germ cell tumor with fried egg appearance (large cells w/ watery cytoplasm), increased ALP
seminoma
testicular germ cell tumor with schiller-duvall bodies (primitive glomeruli)
yolk sac tumor
testicular germ cell tumor with increased hCG
choriocarcinoma
large cytoplasmic vacuoles with reticulate bodies in epithelial cells
chlamydia trachomatis
test for 1˚ syphilis
dark-field microscopy of chancre biopsy
test for 2˚ syphilis
VDRL FIRST, then confirmed with FTA-ABS
test for 3˚ syphilis
FTA-ABS or microhemagglutination test
dont use VDRL in this stage because it reverts to negative
testicular tumor with sheets of undifferentiated cells with focal glandular differentiation
embryonal carcinoma
budding yeast cells and pseudohyphae at 25˚, but short germinating non-septate true hyphae (germ tubes) at body T
candida albicans
type of uterine tumor with well demarcated borders and a whorled pattern on the cut surface
smooth muscle tumor (leiomyomas) that develop from the smooth muscle cells of the myometrium
Aschoff bodies + Anitschkow cells
both associated w/ rheumatic fever
cardiac histology shows echogenic massess w/ bizzarre, markedly enlarged myocytes
rhabdomyomas - frequent cardiac tumor in children <1yo
cardiac histology shows scattered mucopolysaccharide stroma w/ abnormal blood vessels and hemorrhage
myxoma - tend to produce IL6, which causes fever + weight loss
acanthocyte (spurr cell)
liver disease (OH) aß-lipoprotenemia (state of cholesterol dysregulation)
basophilic stippling
ACD
alcohol abuse
Lead poisioning
Thalassemia
Bite cell
G6PD
elliptocyte
hereditary elliptocytosis
macroovalocyte
megaloblastic anemia (also hypersegmented PMNs) marrow failure
ringed sideroblast
SIderoblastic anemia
Schistocytes
DIC
TTP/HUS
traumatic hemolysis (mechanical heart valves)
spherocyte
hereditary spherocytosis
teardrop cell
myelofibrosis
target cell
HbC disease
Asplenia
Liver disease
thalssemia
HLA A3
hemochromatosis
HLA B27
Anklyosing spondylitis
psoriatic arthritis
Arthritis of IBD
Reactive Arthritis
HLA DQ2/DQ8
Celiac disease
HLA DR2
MS
SLE
Goodpasture
Hay fever
HLA DR3
DM Type I
SLE
Graves
HLA DR4
RA
DM Type I
HLA DR5
Pernicious Anemia (∆B12) Hashimotos thyroidtis
HLA subtype associated with Diabetes Type I
HLA-DR3/4