Rapid Review - Classic Labs / Findings (3)

Question 1

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

Answer 1

Ulcerative colitis (loss of haustra)

Question 2

Linear appearance of IgG deposition on glomerular basement membrane

Answer 2

Goodpasture syndrome

Question 3

Low serum ceruloplasmin

Answer 3

Wilson disease (hepatolenticular degeneration)

Question 4

“Lumpy bumpy” appearance of glomeruli on immunofluorescence

Answer 4

Poststreptococcal glomerulonephritis (immune complex deposition of IgG and C3b)

Question 5

Lytic (“hole punched”) bone lesions on x-ray

Answer 5

Multiple myeloma

Question 6

Mammary gland (“blue domed”) cyst

Answer 6

Fibrocystic change of the breast

Question 7

Monoclonal antibody spike

Answer 7

• ƒƒMultiple myeloma (usually IgG or IgA)
• ƒƒMonoclonal gammopathy of undetermined significance (MGUS consequence of aging)
• ƒƒWaldenström (M protein = IgM) macroglobulinemia
• ƒƒ Primary amyloidosis

Question 8

Mucin-filled cell with peripheral nucleus

Answer 8

“Signet ring” (gastric carcinoma)

Question 9

Narrowing of bowel lumen on barium x-ray

Answer 9

“String sign” (Crohn disease)

Question 10

Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis

Answer 10

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

Question 11

Needle-shaped, negatively birefringent crystals

Answer 11

Gout (monosodium urate crystals)

Question 12

Nodular hyaline deposits in glomeruli

Answer 12

Kimmelstiel-Wilson nodules (diabetic nephropathy)

Question 13

Novobiocin response

Answer 13

Sensitive: Staphylococcus epidermidis; resistant: Staphylococcus saprophyticus

Question 14

“Nutmeg” appearance of liver

Answer 14

Chronic passive congestion of liver due to right heart failure

Question 15

“Onion skin” periosteal reaction

Answer 15

Ewing sarcoma (malignant round-cell tumor)

Question 16

Optochin response

Answer 16

Sensitive: Streptococcus pneumoniae; resistant: viridans streptococci

Question 17

Periosteum raised from bone, creating triangular area

Answer 17

Codman triangle on x-ray (osteosarcoma, Ewing sarcoma, pyogenic osteomyelitis)

Question 18

Podocyte fusion or “effacement” on electron microscopy

Answer 18

Minimal change disease (child with nephrotic syndrome)

Question 19

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

Answer 19

Eburnation (osteoarthritis resulting in bony sclerosis)

Question 20

Protein aggregates in neurons from hyperphosphorylation of tau protein

Answer 20

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

Question 21

Psammoma bodies

Answer 21

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

Question 22

Pseudopalisading tumor cells on brain biopsy

Answer 22

Glioblastoma multiforme

Question 23

RBC casts in urine

Answer 23

Acute glomerulonephritis

Question 24

Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells

Answer 24

Reinke crystals (Leydig cell tumor)

Question 25

Renal epithelial casts in urine

Answer 25

Acute toxic/viral renal injury

Question 26

Rhomboid crystals, positively birefringent

Answer 26

Pseudogout (calcium pyrophosphate dihydrate crystals

Question 27

Rib notching

Answer 27

Coarctation of the aorta

Question 28

Ring-enhancing brain lesion in AIDS

Answer 28

Toxoplasma gondii, CNS lymphoma

Question 29

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

Answer 29

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

Question 30

Silver-staining spherical aggregation of tau proteins in neurons

Answer 30

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