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First Aid Rapid Review > First Aid 2012 Rapid Review: Classic lab/diagnostic findings > Flashcards

First Aid 2012 Rapid Review: Classic lab/diagnostic findings Flashcards

1
Q

Anticentromere antibodies

A

Scleroderma (CREST)

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2
Q

Antidesmoglein (epithelial) antibodies

A

Pemphigus vulgaris (blistering)

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3
Q

Anti-GBM antibodies

A

Goodpasture’s syndrome (glomeruloneohritis and hemoptysis)

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4
Q

Antihistone antibodies

A

Drug-induced SLE (SHIPP –> Sulfanomides, Hydralazine, Isoniazid, Phenytoin, Procainamide)

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5
Q

Anti-IgG antibodies

A

Rheumatoid arthritis (systemic inflammation, joint pannus, boutonniere deformity)

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6
Q

Antimitochondial antibodies (AMAs)

A

Primary biliary cirrhosis (female, cholestasis, portal hypertension)

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7
Q

Antineutrophil cytoplasmic antibodies (ANCAs)

A

Vasculitis
c-ANCA –> Wegener’s
p-ANCA –> Microscopic polyangiitis, Churg-Strauss syndrome

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8
Q

Antinuclear antibodies

ANAs: anti-Smith and anti-dsDNA

A

SLE (Type III hypersensitivity)

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9
Q

Antiplatelet antibodies

A

Idiopathic thrombocytopenic purpura (ITP)

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10
Q

Anti-Topoisomerase antibodies

A

Diffuse systemic scleroderma

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11
Q

Anti-transglutaminase/gliadin/endomysial antibodies

A

Celiac disease (diarrhea, distention, weight loss)

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12
Q

“Apple core” lesions on abdominal X-RAY

A

Colorectal cancer (usually left-sided)

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13
Q

Azurophilic granular needles in leukemic blasts

A

Auer rods (AML, especially the promyelocytic [M3], type)

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14
Q

Bacitracin response

A

Sensitive –> Strep pyogenes (Group A)

Resistant –> Strep agalactiae (Group B)

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15
Q

“Bamboo spine” on X-RAY

A

Ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27)

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16
Q

Basophilic nuclear remnants in RBCs

A

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

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17
Q

Basophilic stipplings in RBCs

A

Lead poisoning or sideroblastic anemia

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18
Q

Bloody tap on LP

A

Subarachnoid hemorrhage

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19
Q

“Boot-shaped” heart on X-RAY

A

Tetralogy of Fallot, RVH

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20
Q

Branching gram positive rods with sulfur granules

A

Actinomyces israelii

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21
Q

Bronchogenic apical lung tumor

A

Pancoast tumor (can compress sympathetic ganglion and cause Horner’s syndrome)

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22
Q

“Brown” tumor of bone

A

hemorrhage (hemosiderin) causes brown color of osteolytic cysts. Due to:

  1. Hyperparathyroidism
  2. Osteitis fibrosa cystica
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23
Q

Cardiomegaly with apical atrophy

A

Chaga’s disease (T. cruzi)

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24
Q

Cellular crescents in Bowman’s capsule

A

Rapidly progressive crescentic glomerulonephritis

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25
Q

“Chocolate cyst” of ovary

A

Endometriosis (frequently involves both ovaries)

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26
Q

Circular grouping of dark tumor cells surrounding pale neurofibrils

A

Homer Wright rosettes (neuroblastoma, medulloblastoma, retinoblastoma)

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27
Q

Colonies of mucoid Pseudomonas in lungs

A

Cystic Fibrosis (AR mutation of CFTR resulting in fat-soluble vitamin deficiency and mucus plugs)

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28
Q

Decreased AFP in amniotic fluid/maternal serum

A

Down syndrome or other chromosomal abnormality

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29
Q

Degeneration of dorsal column nerves

A

Tabes dorsalis

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30
Q

Depigmentation of neurons in substantia nigra

A

Parkinson’s disease (basal ganglia disorder)

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31
Q

Desquamated epithelium casts in sputum

A

Curschmann’s spirals (bronchial asthma; can result in whorled mucus plugs)

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32
Q

Disarrayed granulosa cells in eosinophilic fluid

A

Call-Exner bodies (granulosa-theca cell tumor of the ovary)

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33
Q

Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia

A

Koilocytes (HPV)

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34
Q

Enlarged cells with intranuclear inclusion bodies

A

“Owl’s eye” appearance of CMV

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35
Q

Enlarged thyroid cells with ground glass nuclei

A

“Orphan Annie” eye nuclei (papillary carcinoma of the thyroid)

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36
Q

Eosinophilic cytoplasmic inclusions in liver cell

A

Mallory bodies (alcoholic liver disease)

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37
Q

Eosinophilic cytoplasmic inclusion in nerve cell

A

Lewy body (Parkinson’s disease)

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38
Q

Eosinophilic globule in liver

A

Councilman body (toxic or viral hepatitis, often yellow fever)

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39
Q

Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells

A

Rabies virus (Lyssavirus)

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40
Q

Extracellular amyloid deposition in grey matter of brain

A

Senile plaques (Alzheimer’s disease)

41
Q

Giant B cells with bi-lobed nuclei with prominent inclusions (‘owl’s eye”)

A

Reed-Sternberg cells (Hodgkin’s lymphoma)

42
Q

Glomerulus-like structure surrounding vessel in germ cells

A

Schiller-Duval bodies (yolk sac tumor)

43
Q

“Hair-on-end” (crew cut) appearance on X-RAY

A

Beta-thalassemia, sickle cell anemia (marrow expansion)

44
Q

hCG elevated

A

Choriocarcinoma, hydatidiform mole (occurs with and without embryo)

45
Q

Heart nodules (granulomatous)

A

Aschoff bodies (rheumatic fever)

46
Q

Heterophile antibodies

A

Infectious mono

47
Q

Hexagonal, double-pointed, needle-like crystals in bronchial secretions

A

Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)

48
Q

High level of D-dimers

A

DVT, PE, DIC

49
Q

Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify)

A

Ghon complex (primary TB)

50
Q

“Honeycomb lung” on X-RAY

A

Interstitial fibrosis

51
Q

Hypersegmented neutrophils

A

Megaloblastic anemia
B12 deficiency –> neurologic symptoms
Folate deficiency –> no neurologic symptoms

52
Q

Hypochromic, microcytic anemia

A

Iron deficiency, lead poisoning, thalassemia (HbF sometimes present)

53
Q

Increased AFP in amnionic fluid/maternal serum

A

Dating error, anencephaly, spina bifida,

54
Q

Increased uric acid levels

A

Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics

55
Q

Intranuclear eosinophilic droplet-like bodies

A

Cowdry type A bodies (HSV or CMV)

56
Q

Iron-containing nodules in alveolar septum

A

Ferruginous bodies (asbestosis: increased risk of mesothelioma)

57
Q

Large lysosomal vesicles in phagocytes, immunodeficiency

A

Chediak-Higashi disease (congenital failure of phagolysosome formation)

58
Q

“Lead pipe” appearance of colon on X-RAY

A

Ulcerative colitis (loss of haustra)

59
Q

Linear appearance of glomeruli on IF

A

Goodpasture’s syndrome

60
Q

Low serum ceruloplasmin

A

Wilson’s disease (hepatolenticular degeneration)

61
Q

“Lumpy-bumpy” appearance of glomeruli on IF

A

Poststreptococcal glomerulonephritis Iimmune complex deposition of IgG and C3b)

62
Q

Lytic (“hole-punched”) bone lesions on X-RAY

A

Multiple myeloma

63
Q

Mammary gland (“blue-domed”) cyst

A

Fibrocystic change of the breast

64
Q

Monoclonal antibody spike

A
  1. Multiple myeloma (called M protein; usually IgG or IgA)
  2. Monoclonal gammopathy of undetermined significance (MGUS; normal consequence of aging)
  3. Waldenstrom’s macroglobulinemia (M protein = IgM
  4. Primary amyloidosis
65
Q

Monoclonal protein in blood/urine

A

Bence Jones proteins

  1. Multiple myeloma –> Kappa or Lambda Ig light chains in urine
  2. Waldenstrom’s macroglobulinemia –> IgM
66
Q

Mucin-filled cell with peripheral nucleus

A

Signet ring (gastric carcinoma)

67
Q

Narrowing of bowel lumen barium radiograph

A

“String sign” (Crohn’s disease)

68
Q

Needle-shaped, negatively birefringent crystals

A

Gout (monosodium urate crystals)

69
Q

Nodular hyaline deposits in glomeruli

A

Kimmelstiel-Wilson nodules (diabetic nephropathy)

70
Q

Novobiocin response

A

Sensitive –> Staph epidermidis

Resistant –> Staph saprophyticus

71
Q

“Nutmeg” liver

A

Chronic passive congestion of liver due to right heart failure

72
Q

“Onion-skin” periosteal reaction

A

Ewing’s sarcoma (malignant round-cell tumor)

73
Q

Optochin response

A

Sensitive –> Strep pneumoniae

Resistant –> Viridans strep

74
Q

Periosteum raised from bone, creating triangular area

A

Codman’s triangle on X-RAY (osteosarcoma, Ewing’s sarcoma, pyogenic osteomyelitis)

75
Q

Podocyte fusion on EM

A

Minimal change disease (child with nephrotic syndrome)

76
Q

Polished “ivory-like” appearance of bone at cartilage erosion

A

Eburnation (osteoarthritis resulting in bony sclerosis)

77
Q

Protein aggregates in neurons from hyperphosphorylation of protein tau

A

Neurofibrillary tangles (Alzheimer’s disease and CJD)

78
Q

Pseudopalisading tumor cells on brain biopsy

A

Glioblastoma multiforme

79
Q

RBC casts in urine

A

Acute glomerulonephritis

80
Q

Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells

A

Reinke crystals (Leydig cell tumor)

81
Q

Renal epithelial casts in urine

A

Acute toxic/viral nephrosis

82
Q

Rhomboid crystals, positively birefringent

A

Pseudogout (calcium pyrophosphate dihydrate)

83
Q

Rib notching

A

Coarctation of aorta

84
Q

Ring-enhancing brain lesions in AIDS

A

Toxoplasma gondii

85
Q

Sheets of medium-sized lymphoid cells (“starry sky” appearance on histology)

A

Burkitt’s lymphoma (t[8:14] c-myc activation; associated with EBV)

86
Q

Silver-staining spherical aggregation of tau proteins in neurons

A

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

87
Q

“Soap bubble” in femur or tibia on X-RAY

A

Giant cell tumor of bone (generally benign)

88
Q

“Spikes” on basement membrane, “dome-like” sub-epithelial deposits

A

Membranous glomerulonephritis (may progress to nephrotic syndrome)

89
Q

Stacks of RBCs

A

Rouleaux formation (high ESR, multiple myeloma)

90
Q

Stippled vaginal epithelial cells

A

“Clue cells” (Gardnerella vaginalis)

91
Q

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

A

Birbeck granules (histiocytosis X: eosinophilic granuloma)

92
Q

Thrombi made of white/red layers

A

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

93
Q

“Thumb sign” on lateral X-RAY

A

Epiglottitis (H. influenzae)

94
Q

Thyroid-like appearance of kidney

A

Chronic bacterial pyelonephritis

95
Q

“Tram-track” appearance on LM

A

Membranoproliferative glomerulonephritis

96
Q

Triglyceride accumulation in liver cell vacuoles

A

Fatty liver disease (alcoholic or metabolic syndrome)

97
Q

WBCs that look “smudged”

A

CLL (almost always B cell, affects the elderly)

98
Q

“Wire-loop” glomerular appearance on LM

A

Lupus nephropathy

99
Q

Yellow CSF

A

Xanthochromia (previous subarachnoid hemorrhage)

First Aid Rapid Review (4 decks)

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