Rapid Review - Classic Labs Findings Flashcards
1
Q
Anti-centromere Ab
A
Scleroderma (CREST)
2
Q
Anti-desmoglein (epithelial) Ab
A
Pemphigus vulgaris
3
Q
Anti-glomerular basement membrane Ab
A
Goodpasture syndrome
4
Q
Anti-histone Ab
A
Drug-induced SLE
5
Q
Anti-IgG Ab
A
Rheumatoid Arthritis
6
Q
Anti-mitochrondial Ab
A
Primary Biliary Cirrhosis (female, cholestasis, portal HTN)
7
Q
ANCAs
A
Granulomatosis with polyangiitis (Wegeners, PR3-ANCA, c-ANCA)Microscopic Polyangiitis (MPO-ANCA, p-ANCA)Churg Strauss (MPO-ANCA, p-ANCA)
8
Q
Antinuclear Ab, Anti-Smith, Anti-dsDNA
A
SLE (type III hypersensitivity)
9
Q
Antiplatelet Ab
A
Idiopathic thrombocytopenic purpura
10
Q
Anti-topoisomerase Ab
A
Diffuse, systemic scleroderma
11
Q
Anti-transglutaminase, Anti-gliadin, Anti-endomysial Ab
A
Celiac disease (diarrhea, distention, weight loss)
12
Q
“Apple core” on abdominal X-ray
A
Colorectal cancer (usually left-sided)
13
Q
Azurophilic peroxidase + granular inclusions in granulocytes and myeloblasts
A
Auer Rods in AML (especially promyelocytic M3 type)
14
Q
Bacitracin response
A
Resistant: Group B Strep (agalactiae)Sensitive: Group A Strep (pyogenes)Mnemonic: B-BRAS
15
Q
Bamboo spine on X-ray
A
Ankylosing spondylitis (chronic inflammatory arthritis, HLA-B27)
16
Q
Basophilic nuclear remnants in RBC
A
Howell-Jolly bodies (due to splenectomy or dysfunctioning spleen)
17
Q
Basophilic stippling on RBC
A
Lead poisoning, sideroblastic anemia
18
Q
Bloody tap on LP
A
Subarachnoid Hemorrhage
19
Q
Boot-shaped heart on CXR
A
Tetralogy of Fallot, RVH
20
Q
Branching gram+ rods with sulfur granules
A
Actinomyces israelii (anaerobe)
21
Q
Bronchogenic apical lung tumor on imaging
A
Pancoast tumor (can compress sympathetic ganglion -> Horner Syndrome) (can also compress the brachial plexus)
22
Q
“Brown” tumor of bone
A
Hyperparathyroidism or osteitis fibrosa cystica (deposited hemosiderin from hemorrhage gives brown color)
23
Q
Cardiomegaly with apical atrophy
A
Chagas disease (Trypanosoma cruzi)
24
Q
Cellular crescents in Bowman capsule
A
Rapidly progressive glomerulonephritis (RPGN)
25
Chocolate cysts in ovary
Endometriosis, frequently involves both ovaries.
26
Circular grouping of dark tumor cells around pale neurofibrils
Homer-Wright rosettes (neuroblastoma, medulloblastoma, retinoblastoma)
27
Colonies of mucoid Pseudomonas in lungs
Cystic fibrosis (AR mutation in CFTR gene -> fat-soluble vitamin deficiency and mucous plugs)
28
Decreased AFP in amniotic fluid/maternal serum
Down syndrome or other chromosomal abnormality
29
Degeneration of the dorsal column nerves
Tabes dorsalis (tertiary syphilis), subacute combined degeneration (dorsal columns and lateral corticospinal tracts affected)
30
Depigmentation of neurons in the substantia nigra
Parkinsons (basal ganglia disorder: rigidity, resting tremor, bradykinesia)
31
Desquamated epithelium casts in sputum
Curschmann spirals (bronchial asthma; can result in whorled mucous plugs)
32
Disarrayed granulosa cells in eosinophilic fluid
Call-Exner bodies (granulosa-theca cell tumor of the ovary)
33
Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia
Koilocytes (HPV: predisposes to cervical cancer)
34
Enlarged cells with intranuclear inclusion bodies
Owl eye appearance of CMV
35
Enlarged thyroid cells with ground glass nuclei
Orphan Annie eyes nuclei - papillary carcinoma of the thyroid
36
Eosinophilic cytoplasmic inclusion in liver cell
Mallory Body (alcoholic liver disease)
37
Eosinophilic inclusion body in nerve cell
Lewy body (Parkinson disease)
38
Eosinophilic globule in liver
Councilman body (toxic or viral hepatitis, often yellow fever)
39
Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar nerve cells
Negri bodies of rabies
40
Extracellular amyloid deposition in gray matter of the brain
Senile plaques (Alzheimers disease)
41
Giant B cells with bilobed nuclei with prominent inclusions (Owl's eye)
Reed Sternberg cells, (Hodgkin lymphoma)
42
Glomerulus-like structure surrounding vessels in germ cell
Schiller-Duval bodies (yolk sac tumor AKA endodermal sinus tumor)
43
Hair on end (crew-cut) appearance on X-ray
Beta-thalassemia, sickle cell anemia - due to marrow expansion.
44
beta-hCG elevations
Choriocarcinoma, hydatidiform mole (occurs with and without embryo, and multiple pregnancy)Extra note: Can also see increase in 1st and 2nd trimester of Down syndrome (as opposed to general decreases in free beta-hCG in Trisomy 18 and 13)
45
Cart nodules (granulomatous)
Aschoff bodies (rheumatoid fever)
46
Heterophile Antibodies
EBV, Infectious mononucleosis
47
Hexagonal, double-pointed, needle-like crystals in bronchial secretions
Bronchial asthma (Charcot leyden crystals: eosinophilic granules)
48
High level of D-dimers
DVT, PE, DIC
49
Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Ghon complex (primary TB infection)
50
"Honeycomb lung" on CXR or CT
Interstitial pulmonary fibrosis
51
Hypercoagulability (leading to migrating DVTs and vasculitis)
Trousseau syndrome (adenocarcinoma of pancreas or lung)
52
Hypersegmented neutrophils
Megaloblastic anemia (B12 deficiency: neuro symptoms; folate deficiency: no neuro symptoms)
53
Hypertension, hypokalemia, metabolic alkalosis
Conn syndrome (aldosterone-producing adenoma)
54
Hypochromic, microcytic anemia
Iron deficiency anemia, lead poisoning, thalassemia (fetal Hb sometimes present)
55
Increased AFP in amniotic fluid/maternal serum
Dating error usually, anencephaly, spina bifida (neural tube defects)
56
Increased uric acid levels
Gout, Lesch-Nyhan Syndrome, tumor lysis syndrome, loop and thiazide diuretics
57
Intranuclear cytoplasmic droplet-like bodies
Cowdry type A bodies (HSV or CMV)
58
Iron-containing nodules in alveolar septum
Ferruginous bodies (asbestosis: increases chances of mesothelioma)
59
Keratin pearls on a skin biopsy
Squamous cell carcinoma
60
Large lysosomal vesicles in phagocytes, immunodeficiency
Chediak-Higashi disease (congenital failure of phagolysosome formation)
61
"Lead pipe" appearance of colon on barium enema X-ray
Ulcerative Colitis, due to loss of haustra
62
Linear appearance of IgG deposition on glomerular basement membrane
Goodpasture syndrome
63
Low serum ceruloplasmin
Wilson disease (hepatolenticular degeneration)
64
"Lumpy bumpy" appearance of glomeruli on immunofluorescence
Post-strep glomerulonephritis (PSGN) (immune complex formation of IgG and C3b)
65
Lytic (hole-punched) lesions on bones in X-ray
Multiple myeloma
66
Mammary gland ("blue domed") cyst
Fibrocystic change of the breast
67
Monoclonal antibody spike
- Multiple Myeloma (IgG or IgA)- Monoclonal gammopathy of undetermined significance (MGUS), consequence of aging- Waldenstrom (M protein = IgM) macroglobulinemia- Primary amyloidosis
68
Mucin-filled cell with peripheral nucleus
"Signet ring" of gastric carcinoma
69
Narrowing of bowel lumen on barium x-ray
String sign, Crohn's disease
70
Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis
Granulomatosis with polyangiitis (Wegener, anti-PR3, c-ANCA), and Goodpasteur syndrome (anti-basement membrane Ab)
71
Needle-shaped, negatively birefringent crystals
Gout (monosodium urate crystals)
72
Nodular hyaline deposits in glomeruli
Kimmelstiel-Wilson nodules (diabetic nephropathy)
73
Novobiocin response
Resistant: Staph saprophyticusSensitive: Staph epidermidis"NO StRESs"
74
"Nutmeg" appearance of liver
Chronic passive congestion of liver during right heart CHF
75
"Onion skin" periosteal reaction
Ewing sarcoma (malignant round-cell tumor)
76
Optochin Response
Resistant: Strep viridansSensitive: Strep pneumoOVRPS (overpass)
77
Periosteum raised from bone, creating triangular area
Codman triangle (osteosarcoma, ewing sarcoma, pyogenic osteomyelitis)
78
Podocyte fusion or effacement on EM
Minimal change disease (child with nephrotic syndrome)
79
Polished, "ivory-like" appearance of bone at cartilage erosion
Eburnation (Osteoarthritis resultign in bony sclerosis)
80
Protein aggregates in neurons from hyperphosphorylation of tau protein
Neurofibrillary tangles (Alzheimers) and Pick bodies (Pick disease)
81
Psammoma bodies
Meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of the endometrium and ovary
82
Pseudopalisading tumor cells on brain biopsy
Glioblastoma multiforme (GBM)
83
RBC Casts in urine
Acute glomerulonephritis
84
Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells
Reinke crystals (Leydig cell tumor)
85
Renal epithelial casts in urine
Acute toxic/viral renal injury
86
Rhomboid crystals, positively birefringent
Pseudogout (calcium pyrophosphate dihydrate crystals)
87
Rib notching
Coarctation of the aorta
88
Ring-enhancing brain lesion in AIDS
Toxoplasma gondii, CNS lymphoma
89
Sheets of medium-sized lymphoid cells with scattered pale, tingible body-laden macrophages (starry sky)
Burkitt lymphoma (t[8;14] c-myc activation, associated with EBV; "black sky" consists of malignant cells)
90
Silver-staining spherical aggregation of tau proteins in neurons
Pick bodies (Pick disease: progressive dementia, changes in personality)
91
Soap bubble in femur or tibia on X-ray
Giant cell tumor of bone (generally benign)
92
Spikes on basement membrane, dome-like subepithelial deposits
Membranous glomerulonephritis (may progress to nephrotic syndrome)
93
Stacks of RBCs
Rouleaux formation (high ESR, multiple myeloma)
94
Stippled vaginal epithelia
Clue cells (gardnerella vaginalis infection)
95
Tennis racket shapred cytoplasmic organelles (EM) in langerhans cells
Birbeck granules (Langerhans histiocytosis or histiocytosis X: eosinophilic granuloma)
96
Thrombi made of white/red layers
Lines of Zahn (arterial thrombus, layers of platelets and RBCs; implies that thrombosis occurred before death)
97
Thumb sign on lateral x-ray
Epiglottitis (H flu infection)
98
Thyroid-like appearance of kidney
Chronic bacterial pyelonephritis
99
Tram-track appearance of capillary loops of glomerular BM on light microscopy
MPGN
100
Triglyceride accumulation in liver cell vacuoles
Fatty liver disease (alcoholic or metabolic syndromes)
101
Waxy casts with very low urine flow
Chronic end-stage renal disease
102
WBC casts in urine
Acute pyelonephritis
103
WBCs that look smudged
CLL (almost always B cell)
104
Wire loop glomerular capillary appearance on light microscopy
Lupus nephropathy
105
Yellowish CSF
Xanthochromia (blood in CSF due to SAH)
106
Antibody to Phospholipase-A2 receptor
Membranous nephropathy (IgG4)
107
RBCs stacked together in long chains
Rouleaux formation (Multiple Myeloma)
108
Sucrose screening test for activation of complement
Paroxysmal nocturnal hemoglobinuria. Confirmatory tests are flow cytometry of DAF presence (CD55) on RBC or acidified serum test
109
Reddish, pink periodic acid-Schiff positive granules in periportal hepatocytes
Alpha-1-Anti-trypsin deficiency (stuck in granules, unsecreted)
110
Alveolar cells with golden cytoplasmic granules that stain dark blue with Prussian blue staining
Heart failure cells with hemosiderin (macrophages, indicating pulmonary congestion and edema due to left CHF)
111
Skin biopsy with intranuclear inclusions in keratinocytes and multinucleated giant cells.
Positive Tzanck smear - VZV, HSV
112
Positive Sodium cyanide-nitroprusside test (turns red-purple in color)
Detects sulfhydryl groups (presence of cystine in urine -- cystinuria, AR defect of renal proximal tubules (COLA transport))
113
Temporoparietal lobe and/or hippocampal atrophy
Alzheimers
