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Labs/Findings Flashcards

1
Q

Idiopathic pulmonary fibrosis

A

Honeycomb lung on XR or CT

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2
Q

FAP (AD, mutation of APC)

A

Thousands of polyps on colonoscopy

Need colectomy

100% chance progression to colon cancer

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3
Q

Birbeck granules (Langerhans cell histiocytosis)

A

Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells

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4
Q

Hypersegmented neutrophils

A

Megaloblastic anemia (B12 deficiency: neurological symptoms; folate deficiency: no neuro symptoms)

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5
Q

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

A

Thrombi with red and white layers

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6
Q

Howell Jolly bodies (dt splenectomy or nonfunctional spleen)

A

Basophilic nuclear remnants in RBCs

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7
Q

Anti IgG antibodies

A

RA (systemic inflammation, joint pannus, boutonnière and swan neck deformity)

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8
Q

Multiple myeloma

A

Lytic (punched out) bone lesions on X-RAY

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9
Q

Codman’s triangle (raised periosteum)

A

Aggressive bone lesion (ie osteosarcoma, Ewing sarcoma, osteomyelitis)

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10
Q

Warfarin monitoring lab

A

Prothrombin time

Warfarin inhibits activation of 2,7, 9, 10

Warfarin inhibits vitamin K epoxide reductase

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11
Q

Trousseau sign (adenocarcinoma of pancreas or lung)

A

Migratory thrombophlebitis (leading to migrating DVTs and vasculitis)

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12
Q

Glomerulonephritis

A

RBC casts in urine

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13
Q

Low ceruloplasmin

A

Wilson disease (hepatolenticular degeneration; Kayser Fleischer rings dt copper accumulation)

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14
Q

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

A

Depigmentation of neurons in substantia nigra

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15
Q

Kimmelstiel Wilson nodules (diabetic nephropathy)

A

Nodular hyaline deposits in glomeruli

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16
Q

High D dimer

A

DVT
PE
DIC

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17
Q

Fibrocystic change of breast

A

Mammary gland (blue domed) cyst

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18
Q

Elevated hCG

A

Choriocarcinoma
Hydatidiform mole (with abs without embryo)
Multiple pregnancies

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19
Q

Negri bodies of rabies

A

Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar neurons

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20
Q

Chocolate cyst of ovary

A

Endometriosis

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21
Q

Auer rods (AML, especially promyelocytic M3 subtype)

A

Azurophilic peroxidase + granular inclusions in granulocytes and myeloblasts

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22
Q

Koilocytes (HPV predisposes to cervical cancer)

A

Dysplasia squamous cervical cells with raisinoid nuclei and hyperchromasia

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23
Q

3 causes of hypochromic, microcytic anemia

A

Iron deficiency anemia
Lead poisoning
Thalassemia (fetal Hb sometimes present)

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24
Q

Lewy body (Parkinson disease and Lewy body dementia)

A

Eosinophilic cytoplasmic inclusion in neuron

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25
Q

Antineutrophil cytoplasmic antibodies (ANCAs)

A

Microscopic polyangiitis and eosinophilic granulomatosis (MPO-ANCA/p ANCA)
Granulomatosis with polyangiitis (Wheeler; PR3 ANCA/c ANCA)
Primary sclerosing cholangitis (MPO- ANCA/p ANCA)

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26
Q

Rapidly progressive (crescentic) glomerulonephritis

A

Cellular crescents in Bowmans capsule

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27
Q

Tetralogy of Fallot (dt RVH)

A

Boot shaped heart in CXR

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28
Q

Aschoff bodies (rheumatic fever)

A

Heart nodules (granulomatous)

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29
Q

Chronic end stage renal disease

A

Waxy casts with low urine flow

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30
Q

Glioblastoma multiforme

A

Pseudopalisading tumor cells in brain bx

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31
Q

Mallory body (alcoholic liver disease)

A

Eosinophilic cytoplasmic inclusion in liver cell

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32
Q

Colonies of mucoid Pseudomonas in lungs

A

Cystic fibrosis (AR mutation in CFTR gene—> fat soluble vitamin deficiency and mucus plugs)

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33
Q

Cardiac tamponade

A

Electrical alternans (alternating amplitude on EKG)

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34
Q

Owl eye appearance of CMV

A

Enlarged cells with intranuclear inclusion bodies

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35
Q

Psammoma bodies

A

Meningiomas
Papillary thyroid carcinoma
Mesothelioma
Papillary serous carcinoma of endometrium/ovary

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36
Q

Chediak Higashi disease (congenital failure of phagolysosome formation)

A

Large granules in phagocytes

Immunodeficiency

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37
Q

Nutmeg liver

A

Chronic passive congestion of liver dt RHF or Budd Chiari syndrome

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38
Q

Epiglottitis (H influenzae)

A

Thumb sign on lateral X-ray

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39
Q

Croup (parainfluenza virus)

A

Steeple sign on CXR

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40
Q

Thyroid like appearance of kidney

A

Chronic pyelonephritis (usually dt recurrent infections)

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41
Q

Celtic disease (diarrhea, weight loss)

A

Anti ttg/anti gliadin/anti endomysial antibodies

42
Q

Chagas’ disease (Trypanosoma cruzi)

A

Cardiomegaly with apical atrophy

Dilated cardiomyopathy

43
Q

Lead poisoning or sideroblastic anemia

A

Basophilic stippling of RBCs

44
Q

Senile plaques (Alzheimer’s disease)

A

Extracellular amyloid deposition in grey matter of brain

45
Q

Post streptococcal glomerulonephritis (dt deposition of IgG, IgM, C3)

A

Lumpy bumpy appearance of glomeruli on immunofluorescence

46
Q

SLE (type III HSR)

A

+ANA
+anti Smith
+anti dsDNA

47
Q

Homer Wright rosettes (neuroblastoma, medulloblastoma)

A

Circular grouping of dark tumor cells surrounding pale neurofibrils

48
Q

Cowdry type A bodies (VZV or HSV)

A

Intranuclear eosinophilic droplet like bodies

49
Q

Infectious mononucleosis (EBV)

A

Heterophile antibodies

50
Q

Schiller Duval bodies (yolk sac tumor)

A

Glomerulus like structure surrounding vessel in germ cells

51
Q

Wolff Parkinson White syndrome (Bundle of Kent bypasses AV node)

A

Delta wave on EKG
Short PR interval
Supraventricular tachycardia

52
Q

Bamboo spine on XR

A

Ankylosing spondylitis (chronic inflammatory arthritis: HLAB27)

53
Q

“Brown” tumor of bone

A

Hyperparathyroidism or osteitis fibrosa cystica (deposited hemosiderin from hemorrhages gives brown color)

54
Q

Acute pyelonephritis

A

WBC casts in urine

55
Q

Rouleaux formation (high ESR, multiple myeloma)

A

Stacks of RBCs

56
Q

Membranous nephropathy (nephrotic syndrome)

A

Spikes on basement membrane, dome like subepithelial deposits

57
Q

Ring enhancing brain lesions on CT/MRI in AIDS

A

Toxoplasma gondii

CNS lymphoma

58
Q

Diffuse scleroderma

A

+ anti topoisomerase abs

59
Q

Ghon complex (primary TB: Mycobacterium bacilli)

A

Hilar lymphadenopathy

Peripheral granulomatous lesion in middle or lower lung lines (can calcify)

60
Q

Ewing sarcoma (malignant small blue cell tumor)

A

Onion skin periosteum reaction

61
Q

High uric acid levels

A

Gout
Lesch Nyhan syndrome
Tumor lysis syndrome
Loop and thiazides diuretics

62
Q

Clue cells (Gardnerella vaginalis)

A

Bacteria covered vaginas epithelial cells

63
Q

Pancoast tumor (can compress cervical sympathetic chain and cause Horner syndrome)

A

Bronchogenic apical lung tumor on imaging

64
Q

Minimal change disease (child with nephrotic syndrome)

A

Podocyte fusion or effacement on EM

65
Q

Actinomyces israelii

A

Branching Gram + rods with sulfur granules

66
Q

CLL (almost always B cell)

A

Smudged WBCs

67
Q

Reed Sternberg cells (Hodgkin lymphoma)

A

Giant B cells with bilobed nuclei with prominent inclusions (owls eye)

68
Q

Granulomatosis with polyangiitis (Wegener; PR3 ANCA/c ANCA) and Goodpasture syndrome (anti basement membrane abs)

A

Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis

69
Q

Gout (mono sodium irate crystals)

A

Needle shaped

- birefringent crystals

70
Q

Intrinsic renal failure (ie ischemia, toxic injury)

A

Renal epithelial casts in urine

71
Q

Giant cell tumor of bone (generally benign)

A

“Soap bubble” in femur/tibia on XR

72
Q

Xanthochromia (dt subarachnoid hemorrhage)

A

Bloody or yellow tap on lumbar puncture

73
Q

Coarctation of aorta

A

Rib notching (inferior surface on CXR)

74
Q

Reinke crystals (Leydig cell tumor)

A

Rectangular crystal like cytoplasmic inclusions in Leydig cells

75
Q

Pseudogout (calcium pyrophosphate dihydrate crystals)

A

Rhomboid crystals

+ birefringent

76
Q

Signet ring (gastric carcinoma)

A

Mucin filled cell with peripheral nucleus

77
Q

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

A

Silver staining spherical aggregation of tau proteins in neurons

78
Q

Ferruginous bodies (asbestosis: high chance of lung cancer)

A

Iron containing nodules in alveolar septum

79
Q

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

A

Desquamated epithelium casts in sputum

80
Q

Down syndrome, Edwards syndrome

A

LOW AFP in amniotic fluid/maternal serum

81
Q

EBV

A

Atypical lymphocytes

82
Q

Councilman body (viral hepatitis, yellow fever), represents hepatocyte undergoing apoptosis

A

Eosinophilic globule in liver

83
Q

String sign (Crohn disease)

A

Narrowing of bowel lumen on XR

84
Q

Call Exner bodies (granulosa cell tumor of ovary)

A

Disarrayed granulosa cells arranged around collections of eosinophilic fluid

85
Q

Left sided colon cancer

A

Apple core lesion on barium XR

86
Q

Bronchial asthma (Charcot Leyden crystals: eosinophilic granules)

A

Hexagonal, double pointed, needle like crystals in bronchial secretions

87
Q

Anti histone antibodies

A

Drug induced SLE (hydralazine, isoniazid, phenytoin, procainamide)

88
Q

Diffuse proliferative glomerulonephritis (usually seen with SLE)

A

Wire loop glomerular capillary appearance on light microscopy

89
Q

Ulcerative colitis (loss of haustra)

A

Lead pipe appearance of colon on imaging

90
Q

Fatty liver disease (alcoholics or metabolic syndrome)

A

Triglyceride accumulation in liver cell vacuoles

91
Q

Squamous cell carcinoma

A

Keratin pearls on biopsy

92
Q

Goodpasture syndrome (glomerulonephritis and hemoptysis)

A

Anti glomerular basement membrane antibodies

Linear appearance of IgG deposition on glomerular and alveolar basement membranes

93
Q

“Hair on end” (crew cut appearance) on XR

A

Beta thalassemia

Sickle cell disease (bone marrow expansion)

94
Q

Antimitochondrial antibodies (AMA)

A

Primary biliary cholangitis (female, cholestasis, portal HTN)

95
Q

Burkitt lymphoma (t8:14 c myc activation, associated with EBV; starry sky made up of malignant cells)

A

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

96
Q

Neurofibrillary tangles (Alzheimer’s) and Pick bodies (Pick disease)

A

Protein aggregates in neurons from hyperphosphorylation of tau proteins

97
Q

Orphan Annie eyes nuclei (papillary carcinoma of thyroid)

A

Enlarged thyroid cells with ground glass nuclei with central clearing

98
Q

Monoclonal antibody spike

A 
Multiple myeloma (IgG or IgA)
MGUS
Waldenstrom (M protein= IgM) macroglobulinemia 
Primary amyloidosis
99
Q

Membranoproliferative glomerulonephritis

A

Tram track appearance of capillary loops of glomerular basement membranes on EM

100
Q

What tissues cannot use ketone bodies as energy source?

A

RBCs and LIVER

  • no mitochondria
101
Q

Cervical spine in RA patients

A

Risk of subluxation- especially with intubation

Rapid Review (5 decks)

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