Lab Findings (Rapid Review) Flashcards
1
Q
Colonies of Pseudomonas in lungs
A
Cystic fibrosis (autosomal recessive mutation in the CFTR gene -> fat-soluble vitamin deficiency and mucous plugs)
2
Q
Decreased AFP in amniotic fluid/maternal serum
A
Down syndrome, Edwards syndrome
3
Q
Increased beta-hCG, decreased PAPP-A on first trimester screening
A
Down syndrome
4
Q
Increased serum homocysteine, increased methylmalonic acid, decreased folate
A
Vitamin B12 deficiency
5
Q
Anti-histone antibodies
A
Drug-induced SLE
6
Q
Decreased T cells, decreased PTH, decreased Ca2+, absent thymic shadow on CXR
A
Thymic aplasia (DiGeorge syndrome, velocardiofacial syndrome)
7
Q
Recurrent infections, eczema, thrombocytopenia
A
Wiskott-Aldrich syndrome
8
Q
Large granules in phagocytes, immunodeficiency
A
Chediak-Higashi disease (congenital failure of Phagolysosome formation)
9
Q
Optochin sensitivity
A
Sensitive: S pneumoniae; resistant: viridans streptococci (S mutans, S sanguis)
10
Q
Novobiocin response
A
Sensitive: S epidermidis; resistant: S saprophyticus
11
Q
Bacitracin response
A
Sensitive: S pyogenes (group A); resistant: S agalactiae (group B)
12
Q
Branching gram (+) rods with sulfur granules
A
Actinomyces israelii
13
Q
Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
A
Ghon complex (1 deg TB: Myocobacterium bacilli)
14
Q
“Thumb sign” on lateral neck x-ray
A
Epiglottitis (Haemophilus influenzae)
15
Q
Bacteria-covered vaginal epithelial cells
A
“Clue cells” (Gardnerella vaginalis)
16
Q
Dilated cardiomyopathy with apical atrophy, megacolon, megaesophagus
A
Chagas disease (Trypanosoma cruzi)
17
Q
Atypical lymphocytes, heterophile antibodies
A
Infectious mononucleosis (EBV infection)
18
Q
Narrowing of upper trachea and subglottis (Steeple sign) on x-ray
A
Croup (parainfluenza virus)
19
Q
Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar neurons
A
Negri bodies of rabies
20
Q
Ring-enhancing brain lesion on CT/MRI in AIDS
A
Toxoplasma gondii (multiple), CNS lymphoma (may be solitary)
21
Q
Psammoma bodies
A
Meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of the endometrium ovary
22
Q
“Boot-shaped” heart on x-ray
A
Tetralogy of Fallot (due to RVH)
23
Q
Rib notching (inferior surface, on x-ray)
A
Coarctation of the aorta
24
Q
“Delta wave” on ECG, short PR interval, supraventricular tachycardia
A
Wolff-Parkinson-White syndrome (bundle of Kent bypasses AV node)
25
Electrical alternans (alternating amplitude on ECG)
Cardiac tamponade
26
Granuloma with giant cells after pharyngeal infection
Aschoff bodies (rheumatic fever)
27
Empty-appearing nuclei with central clearing of thyroid cells
"Orphan Annie" eyes nuclei (papillary carcinoma of the thyroid)
28
"Brown" tumor of bone
Hyperparathyroidism or osteitis fibrosa cystica (deposited hemosiderin from hemorrhage gives brown color)
29
Hypertension, hypokalemia, metabolic alkalosis
Primary hyperaldosteronism (eg, Conn syndrome)
30
Mucin-filled cell with peripheral nucleus
"Signet ring" cells (diffuse gastric carcinoma)
31
Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies
Celiac disease (diarrhea, weight loss)
32
Narrowing of bowel lumen on barium x-ray
"String sign" (Crohn disease)
33
"Lead pipe" appearance of colon on abdominal imaging
Ulcerative colitis (loss of haustra)
34
Thousands of polyps on colonoscopy
Familial adenomatous polyposis (autosomal dominant, mutation of APC gene)
35
"Apple core" lesion on barium enema x-ray
Colorectal cancer (usually left-sided)
36
Eosinophilic cytoplasmic inclusion in liver cell
Mallory body (alcoholic liver disease)
37
Triglyceride accumulations in liver cell vacuoles
Fatty liver disease (alcoholic or metabolic syndrome)
38
Anti-smooth muscle antibodies (ASMAs), anti-liver/kidney microsomal-1 (anti-LKM1) antibodies
Autoimmune hepatitis
39
"Nutmeg" appearance of liver
Chronic passive congestion of liver due to right heart failure or Budd-Chiari syndrome
40
Animitochondrial antibodies (AMAs)
Primary biliary cholangitis (female, cholestatis, portal hypertension)
41
Low serum ceruloplasmin
Wilson disease (hepatolenticular degeneration; Kayser-Fleischer rings due to copper accumulation)
42
Migratory thrombophlebitis (leading to migrating DVTs and vasculitis)
Trousseau syndrome (adenocarcinoma of pancreas)
43
Hypersegemented neutrophils
Megaloblastic anemia (vitamin B12 deficiency: neurologic symptoms; folate deficiency: no neurologic symptoms)
44
Basophilic nuclear remnants in RBCs
Howell-Jolly bodies (due to splenectomy or nonfunctional spleen)
45
Basophilic stippling of RBCs
Lead poisoning or sideroblastic anemia
46
Hypochromic, microcytic anemia
Iron deficiency anemia, lead poisoning, thalssemia (fetal hemglobin sometimes present)
47
"Hair on end" ("crew cut") appearance on x-ray
Beta-thalassemia, sickle cell disease (marrow expansion)
48
Anti-GpIIb/IIIa antibodies
Immune thrombocytopenia
49
High level of D-dimers
DVT, DIC
50
Giant B cells with bilobed nucleus with prominent inclusions ("owl's eye")
Reed-Sternberg cells (Hodgkin lymphoma)
51
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; "starry sky" make up of malignant cells)
52
Lytic ("punched-out") bone lesions on x-ray
Multiple myeloma
53
Monoclonal spike on serum protein electrophoresis
Myltiple myeloma (usually IgG or IgA), Waldenstrom macroglobulinemia (IgM), Monoclonal gammopathy of undetermined significance
54
Stacks of RBCs
Rouleaux formation (high ESR, multiple myeloma
55
Azurophilic peroxidase (+) granular inclusions in granulocytes and myeloblasts
Auer rods (APL)
56
WBCs that look "smudged"
CLL
57
"Tennis racket"-shaped cytoplasmic organelles (EM) in Langerhans cells
Birbeck granules (Langerhans cell histiocytosis)
58
"Soap bubble" in femur or tibia on x-ray
Giant cell tumor of bone (generally benign)
59
Raised periosteum (creating a "Codman triangle")
Aggressive bone lesion (eg, osteosarcoma, Ewing sarcoma)
60
"Onion skin" periosteal reaction
Ewing sarcoma (malignant small blue cell tumor)
61
Anti-IgG antibodies
Rheumatoid arthritis (systemic inflammation, joint pannus, boutonniere and swan neck deformities)
62
Rhomboid crystals, (+) birefringent
Pseudogout (calcium pyrophosphate dihydrate crystals)
63
Needle-shaped, (-) birefringent crystals
Gout (monosodium urate crystals)
64
Increased uric acid levels
Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide duretics
65
"Bamboo spine" on x-ray
Ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27)
66
Antinuclear antibodies (ANAs: anti-Smith and anti-dsDNA)
SLE (type III hypersensitivity)
67
Antineutrophil cytoplasmic antibodies (ANCAs)
Microscopic polyangiitis, eosinophilic granulomatosis with polyangiitis, and primary sclerosing cholangitis (MPO-ANCA/p-ANCA); granulomatosis with polyangiitis (PR3-ANCA/c-ANCA)
68
Anticentromere antibodies
Limited scleroderma (CREST syndrome)
69
Anti-topoisomerase antibodies
Diffuse scleroderma
70
Anti-desmoglein (anti-desmosome) antibodies
Pemphigus vulgaris
71
Antihemidesmosome antibodies
Bullous pemphigoid
72
Keratin pearls on a skin biopsy
Squamous cell carcinoma
73
Increased AFP in amniotic fluid/maternal serum
Dating error, anencephaly, spina bifida (open neural tube defects)
74
Bloody or yellow tap on lumbar puncture
Xanthochromia (due to subarachnoid hemorrhage)
75
Eosinophilic cytoplasmic inclusion in neuron
Lewy body (Parkinson disease and Lewy body dementia)
76
Extracellular amyloid deposition in gray matter of brain
Senile plaques (Alzheimer disease)
77
Depigmentation of neurons in substantia nigra
Parkinson disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia)
78
Protein aggregates in neurons from hyperphosphorylation of tau protein
Neurofibrillary tangles (Alzheimer disease) and Pick bodies (Pick disease)
79
Silver-staining spherical aggregation of tau proteins in neurons
Pick bodies (frontotemporal dementia: progressive dementia, changes in personality)
80
Pseudopalisading pleomorphic tumor cells on brain biopsy
Glioblastoma multiforme
81
Small blue cells surrounding central area of neuropil
Homer-Wright rosettes (neuroblastoma, medulloblastoma)
82
"Waxy" casts with very low urine flow
Chronic end-stage renal disease
83
WBC casts in urine
Acute pyelonephritis, transplant rejection, tubulointerstitial inflammation
84
RBC casts in urine
Glumerulonephritis
85
Anti-glomerular basement membrane antibodies
Goodpasture syndrome (glomerulonephritis and hemoptysis)
86
Cellular cresecents in Bowman capsure
Rapidly progressive (crescentic) glomerulonephritis
87
"Wire loop" glomerular capillary appearance on light microscopy
Diffuse proliferative glomeruloephritis (usually seen with lupus)
88
Linear appearance of IgG deposition on glomerular and alveolar basement membranes
Goodpasture syndrome
89
"Lumpy bumpy" appearance of glomeruli on immunofluorescence
Poststreptococcal glomerulonephritis (due to deposition of IgG, IgM, and C3)
90
Necrotizing vasulitis (lungs) and necrotizing glomerulonephritis
Granulomatosis with poly angiitis (PR3-ANCA/c-ANCA) and Goodpasture syndrome (anti-basement membrane antibodies)
91
"Tram-track" appearance of capillary loops of glomerular basement membranes on light microscopy
Membranoproliferative glomerulonephritis
92
Nodular hyaline deposits in golmeruli
Kimmelstiel-Wilson nodules (diabetic nephropathy)
93
Podocyte fusion or "effacement" on electron microscopy
Minimal change disease (child with nephrotic syndrome)
94
"Spikes" on bassement membrane, "domelike" subepithelial deposits
Membranous nephropathy (nephrotic syndrome)
95
Thyroidlike appearance of kidney
Chronic pyelonephritis (usually due to recurrent infections)
96
Granular casts in urine
Acute tubular necrosis (eg, ischemia or toxic injury)
97
hCG elevated
Multifetal gestation, hydatidiform moles, choriocarcinomas, Down syndrome
98
Dysplastic squamous cervical cells with "raisinoid" nuclei and hyperchromasia
Koilocytes (HPV: predisposes to cervical cancer)
99
Sheets of uniform "fried egg" cells, increased hCG, increased LDH
Dysgerminoma
100
Glomeruluslike structure surrounding vessel in germ cells
Schiller-Duval bodies (yolk sac tumor)
101
Disarrayed granulosa cells arranged around collections of eosinophilic fluid
Call-Exner bodies (granulosa cell tumor of the ovary)
102
"Chocolate cyst" of ovary
Endometriosis (frequently involves both ovaries)
103
Mammary gland ("blue domed") cyst
Fibrocystic change of the breast
104
Rectangular, crystal-like, cytoplasmic inclusion in Leydig cells
Reinke crystals (Leydig cell tumor)
105
Thrombi made of white/red layers
Lines of Zahn (arterial thrombus, layers of platelets/RBCs)
106
Hexagonal, double-pointed, needlelike crystals in bronchial secretions
Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)
107
Desquamated epithelium casts in sputum
Curschmann spirals (bronchial asthma; can result in whorled mucous plugs)
108
"Honeycomb lung" on x-ray or CT
Idiopathic pulmonary fibrosis
109
Iron-containing nodules in alveolar septum
Ferruginous bodies (asbestosis: increased chance of lung cancer)
110
Bronchogenic apical lung tumor on imaging
Pancoast tumor (can compress cervical sympathetic chain and cause Horner syndrome)
