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Step 1 > Rapid Review - Classic Labs Findings > Flashcards

Rapid Review - Classic Labs Findings Flashcards

1
Q

Anti-centromere Ab

A

Scleroderma (CREST)

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2
Q

Anti-desmoglein (epithelial) Ab

A

Pemphigus vulgaris

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3
Q

Anti-glomerular basement membrane Ab

A

Goodpasture syndrome

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4
Q

Anti-histone Ab

A

Drug-induced SLE

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5
Q

Anti-IgG Ab

A

Rheumatoid Arthritis

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6
Q

Anti-mitochrondial Ab

A

Primary Biliary Cirrhosis (female, cholestasis, portal HTN)

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7
Q

ANCAs

A

Granulomatosis with polyangiitis (Wegeners, PR3-ANCA, c-ANCA)Microscopic Polyangiitis (MPO-ANCA, p-ANCA)Churg Strauss (MPO-ANCA, p-ANCA)

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8
Q

Antinuclear Ab, Anti-Smith, Anti-dsDNA

A

SLE (type III hypersensitivity)

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9
Q

Antiplatelet Ab

A

Idiopathic thrombocytopenic purpura

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10
Q

Anti-topoisomerase Ab

A

Diffuse, systemic scleroderma

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11
Q

Anti-transglutaminase, Anti-gliadin, Anti-endomysial Ab

A

Celiac disease (diarrhea, distention, weight loss)

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12
Q

“Apple core” on abdominal X-ray

A

Colorectal cancer (usually left-sided)

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13
Q

Azurophilic peroxidase + granular inclusions in granulocytes and myeloblasts

A

Auer Rods in AML (especially promyelocytic M3 type)

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14
Q

Bacitracin response

A

Resistant: Group B Strep (agalactiae)Sensitive: Group A Strep (pyogenes)Mnemonic: B-BRAS

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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 RBC

A

Howell-Jolly bodies (due to splenectomy or dysfunctioning spleen)

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17
Q

Basophilic stippling on RBC

A

Lead poisoning, 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 CXR

A

Tetralogy of Fallot, RVH

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20
Q

Branching gram+ rods with sulfur granules

A

Actinomyces israelii (anaerobe)

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21
Q

Bronchogenic apical lung tumor on imaging

A

Pancoast tumor (can compress sympathetic ganglion -> Horner Syndrome) (can also compress the brachial plexus)

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22
Q

“Brown” tumor of bone

A

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

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23
Q

Cardiomegaly with apical atrophy

A

Chagas disease (Trypanosoma cruzi)

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24
Q

Cellular crescents in Bowman capsule

A

Rapidly progressive glomerulonephritis (RPGN)

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25
Q

Chocolate cysts in ovary

A

Endometriosis, frequently involves both ovaries.

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26
Q

Circular grouping of dark tumor cells around 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 in CFTR gene -> fat-soluble vitamin deficiency and mucous 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 the dorsal column nerves

A

Tabes dorsalis (tertiary syphilis), subacute combined degeneration (dorsal columns and lateral corticospinal tracts affected)

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30
Q

Depigmentation of neurons in the substantia nigra

A

Parkinsons (basal ganglia disorder: rigidity, resting tremor, bradykinesia)

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31
Q

Desquamated epithelium casts in sputum

A

Curschmann spirals (bronchial asthma; can result in whorled mucous 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: predisposes to cervical cancer)

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34
Q

Enlarged cells with intranuclear inclusion bodies

A

Owl eye appearance of CMV

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35
Q

Enlarged thyroid cells with ground glass nuclei

A

Orphan Annie eyes nuclei - papillary carcinoma of the thyroid

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36
Q

Eosinophilic cytoplasmic inclusion in liver cell

A

Mallory Body (alcoholic liver disease)

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37
Q

Eosinophilic inclusion body in nerve cell

A

Lewy body (Parkinson 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 and cerebellar nerve cells

A

Negri bodies of rabies

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40
Q

Extracellular amyloid deposition in gray matter of the brain

A

Senile plaques (Alzheimers disease)

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41
Q

Giant B cells with bilobed nuclei with prominent inclusions (Owl’s eye)

A

Reed Sternberg cells, (Hodgkin lymphoma)

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42
Q

Glomerulus-like structure surrounding vessels in germ cell

A

Schiller-Duval bodies (yolk sac tumor AKA endodermal sinus tumor)

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43
Q

Hair on end (crew-cut) appearance on X-ray

A

Beta-thalassemia, sickle cell anemia - due to marrow expansion.

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44
Q

beta-hCG elevations

A

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)

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45
Q

Cart nodules (granulomatous)

A

Aschoff bodies (rheumatoid fever)

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46
Q

Heterophile Antibodies

A

EBV, Infectious mononucleosis

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 infection)

50
Q

“Honeycomb lung” on CXR or CT

A

Interstitial pulmonary fibrosis

51
Q

Hypercoagulability (leading to migrating DVTs and vasculitis)

A

Trousseau syndrome (adenocarcinoma of pancreas or lung)

52
Q

Hypersegmented neutrophils

A

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

53
Q

Hypertension, hypokalemia, metabolic alkalosis

A

Conn syndrome (aldosterone-producing adenoma)

54
Q

Hypochromic, microcytic anemia

A

Iron deficiency anemia, lead poisoning, thalassemia (fetal Hb sometimes present)

55
Q

Increased AFP in amniotic fluid/maternal serum

A

Dating error usually, anencephaly, spina bifida (neural tube defects)

56
Q

Increased uric acid levels

A

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

57
Q

Intranuclear cytoplasmic droplet-like bodies

A

Cowdry type A bodies (HSV or CMV)

58
Q

Iron-containing nodules in alveolar septum

A

Ferruginous bodies (asbestosis: increases chances of mesothelioma)

59
Q

Keratin pearls on a skin biopsy

A

Squamous cell carcinoma

60
Q

Large lysosomal vesicles in phagocytes, immunodeficiency

A

Chediak-Higashi disease (congenital failure of phagolysosome formation)

61
Q

“Lead pipe” appearance of colon on barium enema X-ray

A

Ulcerative Colitis, due to loss of haustra

62
Q

Linear appearance of IgG deposition on glomerular basement membrane

A

Goodpasture syndrome

63
Q

Low serum ceruloplasmin

A

Wilson disease (hepatolenticular degeneration)

64
Q

“Lumpy bumpy” appearance of glomeruli on immunofluorescence

A

Post-strep glomerulonephritis (PSGN) (immune complex formation of IgG and C3b)

65
Q

Lytic (hole-punched) lesions on bones in X-ray

A

Multiple myeloma

66
Q

Mammary gland (“blue domed”) cyst

A

Fibrocystic change of the breast

67
Q

Monoclonal antibody spike

A
  • Multiple Myeloma (IgG or IgA)- Monoclonal gammopathy of undetermined significance (MGUS), consequence of aging- Waldenstrom (M protein = IgM) macroglobulinemia- Primary amyloidosis
68
Q

Mucin-filled cell with peripheral nucleus

A

“Signet ring” of gastric carcinoma

69
Q

Narrowing of bowel lumen on barium x-ray

A

String sign, Crohn’s disease

70
Q

Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis

A

Granulomatosis with polyangiitis (Wegener, anti-PR3, c-ANCA), and Goodpasteur syndrome (anti-basement membrane Ab)

71
Q

Needle-shaped, negatively birefringent crystals

A

Gout (monosodium urate crystals)

72
Q

Nodular hyaline deposits in glomeruli

A

Kimmelstiel-Wilson nodules (diabetic nephropathy)

73
Q

Novobiocin response

A

Resistant: Staph saprophyticusSensitive: Staph epidermidis”NO StRESs”

74
Q

“Nutmeg” appearance of liver

A

Chronic passive congestion of liver during right heart CHF

75
Q

“Onion skin” periosteal reaction

A

Ewing sarcoma (malignant round-cell tumor)

76
Q

Optochin Response

A

Resistant: Strep viridansSensitive: Strep pneumoOVRPS (overpass)

77
Q

Periosteum raised from bone, creating triangular area

A

Codman triangle (osteosarcoma, ewing sarcoma, pyogenic osteomyelitis)

78
Q

Podocyte fusion or effacement on EM

A

Minimal change disease (child with nephrotic syndrome)

79
Q

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

A

Eburnation (Osteoarthritis resultign in bony sclerosis)

80
Q

Protein aggregates in neurons from hyperphosphorylation of tau protein

A

Neurofibrillary tangles (Alzheimers) and Pick bodies (Pick disease)

81
Q

Psammoma bodies

A

Meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of the endometrium and ovary

82
Q

Pseudopalisading tumor cells on brain biopsy

A

Glioblastoma multiforme (GBM)

83
Q

RBC Casts in urine

A

Acute glomerulonephritis

84
Q

Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells

A

Reinke crystals (Leydig cell tumor)

85
Q

Renal epithelial casts in urine

A

Acute toxic/viral renal injury

86
Q

Rhomboid crystals, positively birefringent

A

Pseudogout (calcium pyrophosphate dihydrate crystals)

87
Q

Rib notching

A

Coarctation of the aorta

88
Q

Ring-enhancing brain lesion in AIDS

A

Toxoplasma gondii, CNS lymphoma

89
Q

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

A

Burkitt lymphoma (t[8;14] c-myc activation, associated with EBV; “black sky” consists of malignant cells)

90
Q

Silver-staining spherical aggregation of tau proteins in neurons

A

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

91
Q

Soap bubble in femur or tibia on X-ray

A

Giant cell tumor of bone (generally benign)

92
Q

Spikes on basement membrane, dome-like subepithelial deposits

A

Membranous glomerulonephritis (may progress to nephrotic syndrome)

93
Q

Stacks of RBCs

A

Rouleaux formation (high ESR, multiple myeloma)

94
Q

Stippled vaginal epithelia

A

Clue cells (gardnerella vaginalis infection)

95
Q

Tennis racket shapred cytoplasmic organelles (EM) in langerhans cells

A

Birbeck granules (Langerhans histiocytosis or histiocytosis X: eosinophilic granuloma)

96
Q

Thrombi made of white/red layers

A

Lines of Zahn (arterial thrombus, layers of platelets and RBCs; implies that thrombosis occurred before death)

97
Q

Thumb sign on lateral x-ray

A

Epiglottitis (H flu infection)

98
Q

Thyroid-like appearance of kidney

A

Chronic bacterial pyelonephritis

99
Q

Tram-track appearance of capillary loops of glomerular BM on light microscopy

100
Q

Triglyceride accumulation in liver cell vacuoles

A

Fatty liver disease (alcoholic or metabolic syndromes)

101
Q

Waxy casts with very low urine flow

A

Chronic end-stage renal disease

102
Q

WBC casts in urine

A

Acute pyelonephritis

103
Q

WBCs that look smudged

A

CLL (almost always B cell)

104
Q

Wire loop glomerular capillary appearance on light microscopy

A

Lupus nephropathy

105
Q

Yellowish CSF

A

Xanthochromia (blood in CSF due to SAH)

106
Q

Antibody to Phospholipase-A2 receptor

A

Membranous nephropathy (IgG4)

107
Q

RBCs stacked together in long chains

A

Rouleaux formation (Multiple Myeloma)

108
Q

Sucrose screening test for activation of complement

A

Paroxysmal nocturnal hemoglobinuria. Confirmatory tests are flow cytometry of DAF presence (CD55) on RBC or acidified serum test

109
Q

Reddish, pink periodic acid-Schiff positive granules in periportal hepatocytes

A

Alpha-1-Anti-trypsin deficiency (stuck in granules, unsecreted)

110
Q

Alveolar cells with golden cytoplasmic granules that stain dark blue with Prussian blue staining

A

Heart failure cells with hemosiderin (macrophages, indicating pulmonary congestion and edema due to left CHF)

111
Q

Skin biopsy with intranuclear inclusions in keratinocytes and multinucleated giant cells.

A

Positive Tzanck smear - VZV, HSV

112
Q

Positive Sodium cyanide-nitroprusside test (turns red-purple in color)

A

Detects sulfhydryl groups (presence of cystine in urine – cystinuria, AR defect of renal proximal tubules (COLA transport))

113
Q

Temporoparietal lobe and/or hippocampal atrophy

A

Alzheimers

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