Rapid Review - Classic Labratory Findings Flashcards
Increased AFP in amniotic fluid/maternal serum
Dating error, anencephaly, spina bifida (neural tube defects)
Anti-centromere antibodies
Scleroderma (CREST)
Anti-desmoglein (anti-desmosome) antibodies
Pemphigus Vulgaris (blistering)
Anti-glomerular basement membrane antibodies
Goodpasture’s Syndrome (glomerulonephritis and hemoptysis)
Anti-histone antibodies
Drug Induced SLE (hydralazine, isoniazid, phenytoin, procainamide)
Anti-cyclic citrullinated peptide (CCP)
Anti-IgG antibodies
Rheumatoid Arthritis (systemic inflammation, joint pannus, boutonniere deformity)
Anti-mitochondrial antibodies
Primary Biliary Cirrhosis (female, cholestasis, portal hypertension)
Anti-neutrophilic cytoplasmic antibodies
p-ANCA: Microscopic polyangiitis and eosinophilic granulomatosis (Churg-Strauss Syndrome)
c-ANCA: Granulomatosis with polyangiitis (Wegeners)
Anti-nuclear antibodies (ANA: anti-smith and anti-dsDNA)
Lupus (type 3 hypersensitivity)
Anti-platelet antibodies
Idiopathic thrombocytopenic purpura
Anti-topoisomerase antibodies
Diffuse systemic scleroderma
Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies
Celiac Disease (diarrhea and weight loss)
“Apple core” lesion on barium enema x-ray
Colorectal Cancer (usually left sided)
Atypical Lymphocytes
EBV
Azurophilic peroxidase positive granular inclusions in granulocytes and myeloblasts
Auer Rods (AML - promyelocytic/M3 type)
Bacitracin Response
Sensitive = Strep Pyogenes (group A) Resistant = Strep 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 or yellow tap on lumbar puncture
Subarachnoid Hemorrhage
“Boot-shaped” heart on x-ray
Tetralogy of Fallot (due to RVH)
Branching gram positive rods with sulfur granules
Actinomyces Israelii
Bronchogenic apical lung tumor on imaging
Pancoast tumor (can compress cervical sympatheic ganglia and cause Horner’s Syndrome)
“Brown” tumor of bone
Hyperparathyroidism
Osteitis Fibrosa Cystica (deposited hemosiderin from from hemorrhage gives from color)
Cardiomegaly with apical atrophy
Chagas Disease (Trypanosoma Cruzi)
Cellular crescents in bowmans capsule
Rapidly progressing crescentic glomerulonephritis
Chocolate cysts on ovary(s)
Endometriosis
Circular grouping of dark tumor cells surrounding pale neurofibrils
Homer-Wright Rosettes (neuroblastoma and medulloblastoma)
Colonies of mucoid pseudomonas in lungs
Cystic Fibrosis (autosomal recessive mutation in CFTR gene, fat-soluble vitamin deficiency and mucus plugs)
Decreased AFP in amniotic fluid/maternal serum
Down Syndrome or other chromosomal abnormalities
Degeneration of dorsal column fibers
Tabes Dorsalis (tertiary syphilis) Subacute combined degeneration (dorsal columns, lateral corticospinal, spinocerebellar tracts affected)
“Delta Wave” on EKG, short PR interval, supraventricular tachycardia
Wolff-Parkinson-White Syndrome (Bundle of Kent bypasses the AV node)
Depigmentation of neurons in the substantia nigra
Parkinson’s Disease
Desquamated epithelium casts in the sputum
Curschmann spirals (bronchial asthma, can results in whorled mucous plugs)
Disarrayed granulosa cells arranged around collections of eosinophilic fluid
Call-Exner Bodies (Granulosa Cell Tumor of the Ovary)
Dysplastic squamous cervical cells with raisinoid nuclei and hyperchromasia
Koilocytes (HPV)
Electrical Alternans (alternating amplitude on EKG)
Pericardial Tamponade
Enlarged cells with intranuclear inclusion bodies
“Owl eye” appearance of CMV
Enlarged thyroid cells with ground-glass nuclei with central clearing
“Orphan Annie Eyes” nuclei (papillary carcinoma of the thyroid)
Eosinophilic cytoplasmic inclusion in a liver cell
Mallory Body (Alcoholic Liver Disease)
Eosinophilic cytoplasmic inclusion in a neuron
Lewy Body (Parkinson Disease or Lewy Body Dementia)
Eosinophilic globule in liver
Councilman body (viral hepatitis, yellow fever) Represents a hepatocyte undergoing apoptosis
Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar neurons
Negri Bodies of Rabies
Extracellular amyloid deposition in gray matter of the brain
Senile Plaques of Alzheimer Disease
Giant B cells with bilobed nuclei with prominent inclusions (Owl’s Eye)
Reed-Sternberg Cells (hodgkins lymphoma)
Glomerulus-like structure surrounding vessels in germ cells
Schiller-Duval Bodies (Yolk Sac Tumor)
“Hair on end” or “Crew cut” appearance on x-ray
B-Thalassemia or Sickle Cell Disease
Due to bone marrow expansion
hCG elevation
Choriocarcinoma
Hyatidaform mole
Heart Nodules (Granulomatous)
Aschoff Bodies (Rheumatic Fever)
Heterophile Antibodies
Infectious mononucleosis (EBV)
Hexagonal, double pointed, needle-like crystals in bronchial secretions
Bronchial Asthma (Charcot-Leydin Crystals; eosinophilic granules)
High level of D-Dimers
PE, DVT, DIC
Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes
Ghon Complex (primary TB)
“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 (Folate - no neuro symptoms; B12- neuro symptoms)
Hypertension, Hypokalemia, Metabolic Alkalosis
Primary Hyperaldosteronism (Conn Syndrome)
Hypochromatic, microcytic anemia
Iron deficiency, lead poisoning, thalassemia
Intranuclear eosinophlic droplet-like bodies
Cowdry Type A Bodies (HSV or VZV)
Iron-containing nodules in alveolar septum
Ferruginous Bodies (asbestosis)
Keratin pearls on skin biopsy
Squamous Cell Carcinoma
Large granules in phagocytes, immunodeficiency
Chediak-Higashi Disease (congenital failure of phagolysosome formation)
“Lead pipe” appearance of colon on abdominal imaging
Ulcerative Colitis (due to loss of haustra)
Linear appearance of IgG deposition on glomerular and alveolar basement membranes
Goodpasture Syndrome
Low serum ceruloplasmin
Wilson Disease (hepatolenticular degeneration)
“Lumpy Bumpy” appearance of glomeruli on immunoflorescence
Poststreptococcal glomerulonephritis (due to deposition of IgG, IgM, C3)
Lytic (punched out) 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)
MGUS
Waldenstrom (M Protein - IgM) Macroglobinemia
Primary amyloidosis
Mucin-filled cell with peripheral nucleus
Signet Ring (Gastric Carcinoma)
Narrowing of bowel lumen on barium x-ray
String Sign (Crohns Disease)
Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis
Granulomatosis with polyangititis (Wegener, c-ANCA) Goodpasture Sydrome (anti-basement membrane antibodies)
Needle-shaped negatively bifringent crystals
Gout (monosodium urate crystals)
Nodular hyaline deposits in the glomeruli
Kimmelstiel-Wilson Nodules (diabetic nephropathy)
Novobiocin Response
Sensitive = Staph Epidermidis Resistant = Staph Saprophyticus
“Nutmeg” Appearance of Liver
Chronic passive congestion of liver due to right heart failure or Budd-Chiari Syndrome
“Onion Skin” periosteal reaction
Ewing Sarcoma (malignant small blue cell tumor)
Optochin Response
Sensitive = Strep Pneumoniae Resistant = Strep Viridans (mutans, sanguis)
Podocyte fusion or effacement on electron microscopy
Minimal change disease (child with nephrotic syndrome)
Polished “ivory life” bone at cartilage erosion
Eburnation (osteoarthritis resulting in body sclerosis)
Protein aggregates in neuron from hyperphosphorylation of tau protein
Neurofibrillary tangles (Alzheimer Disease) Pick Bodies (Picks Disease)
Psammoma Bodies
Meningiomas
Papillary thyroid carcinoma
Mesothelioma
Papillary serous carcinoma of the endometrium and ovary
Pseudopalisading tumor cells on brain biospy
Gliobastoma Multiforme
Raised Periosteum (creating a codman triangle)
Agressive bone lesion (Osteosarcoma, Ewing Sarcoma Osteomyelitis)
RBC casts in urine
Glomerulonephritis
Rectangular, crystal-like, cytoplasmic inclusions in Lehdig cells
Reinke Crystals (Leydig cell tumor)
Recurrent infections, eczema, thrombocytopenia
Wiscott-Aldrich Syndrome
Renal Epithelial Casts in Urine
Intrinsic renal failure (ischemia or toxic injury)
Rhomboid crystals, positively bifringent
Pseudogout (Calcium pyrophosphate dihydrate crystals)
Rib notching (inferior surface) on x-ray
Coarctation of the aorta
Ring-enhancing brain lesions on CT/MRI in AIDS patient
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)
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 the bone (usually benign)
“Spikes” on basement membrane, “dome-like” subepithelial deposits
Membranous nephropathy (nephrotic syndrome)
Stacks of RBCs
Rouleaux formation (high ESR, multiple myeloma)
“Steeple” sign on frontal CXR
Croup (parainfluenza virus)
Stippled vaginal epithelial cells
“Clue Cells” (Garderella Vaginalis)
Strep Bovis Bacteremia
Colon Cancer
“Tennis racket” shaped cytoplasmic organelles (EM) in Langerhans Cells
Birbeck Granules (langerhans cell histiocytosis)
Thousands of polyps on colonoscopy
FAP (autosomal dominant, mutation of APC gene)
Thrombi made of white/red layers
Lines of Zahn (arterial thrombus, layers of platelets/RBCs)
“Thumb-Sign” on lateral neck x-ray
Epiglottitis (H. Influenzae)
Thyroid-like appearance of kidney
Chronic Pyelonephritis (usually due to recurrent infections)
“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)
Increased uric acid levels
Gout
Lesch-Nyhan Syndrome
Tumor Lysis Syndrome
Loop and Thiazide Diuretics
“Waxy” casts with very low urine flow
Chronic end-stage liver disease
WBC casts in urine
Acute pyleonephritis
WBCs that look “smudged”
CLL (almost always B cell)
“Wire Loop” glomerular capillary appearance on light microscopy
Diffuse Proliferative Glomerulonephritis (usually seen with Lupus)
Yellowish CSF
Xanthochromia (due to subarachnoid hemorrhage)