Classic Lab Findings Flashcards

1
Q

Anticentromere antibodies

A

Scleroderma (CREST)

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2
Q

Antidesmoglein (epithelial antibodies)

A

Pemphigus vulgaris (blistering)

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3
Q

Anti-glomerular basement membrane antibodies

A

Goodpasture’s syndrome (glomerulonephritis and hemoptysis)

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4
Q

Antihistone antibodies

A

Drug-induced SLE

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5
Q

Anti-IgG antibodies

A

Rheumatoid arthritis (systemic inflammation, joint pannus, boutonniere deformity)

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6
Q

Antimitochondrial antibodies (AMAs)

A

Primary biliary cirrhosis (female, cholestasis, portal hypertension)

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7
Q

Antineutrophil cytoplasmic antibody

A

ANCAs (c-ANCA = Wegner’s, p-ANCA = microscopic polyangiitis, Churg-Strauss syndrome)

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8
Q

Antinuclear antibodies (ANA: anti-Smith and anti-dsDNA)

A

SLE (type III hypersensitivity)

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9
Q

Antiplatelet antibodies

A

ITP

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10
Q

Anti-topoisomerase antibodies

A

diffuse systemic scleroderma

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11
Q

Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies

A

Celiac disease (diarrhea, distention, weight loss)

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12
Q

Apple core lesion on abdominal x-ray

A

colorectal cancer (usually left-sided)

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13
Q

Azurophilic granular needles in leukemic blasts

A

Auer rods (AML especially M3)

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14
Q

Bacitracin response

A

Sensitive = S. pyogenes (Group A); Resistant = S. agalactiae (Group B)

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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 RBCs

A

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

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17
Q

Basophilic stippling of RBCs

A

Lead poisoning or 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 X-ray

A

Tetralogy of Fallot, RVH

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20
Q

Branching gram-positive rods with sulfur granules

A

Actinomyces israelii

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21
Q

Bronchogenic apical lung tumor

A

Pancoast tumor (can compress the sympathetic ganglion and cause Horner’s syndrome)

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22
Q

Brown tumor of bone

A

Hemorrhage (hemosiderin) causes brown color of osteolytic cysts due to hyperparathyroidism and Osteitis fibrosa cystica

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23
Q

Cardiomegaly with apical atrophy

A

Chagas’ disease (trypanosoma cruzi)

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24
Q

Cellular crescents on Bowmann’s capsule

A

Rapidly progressive crescentic glomerulonephritis

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25
Q

Chocolate cyst of ovary

A

Endometriosis (frequently involves both ovaries)

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26
Q

Circular grouping of dark tumor cells, surrounding pale neurofibrils

A

Homer wright rosettes (Neuroblastoma, medulloblastoma, retinoblastoma)

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27
Q

Colonies of mucoid Pseudomonas in lung

A

CF (AR mutation in CFTR gene results in fat-soluble vitamin deficiency and mucous plugs)

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28
Q

Decreased alpha-fetoprotein in amniotic fluid/maternal serum

A

Down syndrome or other chromosomal abnormality

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29
Q

Degeneration of dorasl column nerves

A

Tabes dorsalis (tertiary syphilis)

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30
Q

Depigmentation of neurons in substantia nigra

A

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

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31
Q

Desquamated epithelium casts in sputum

A

Curschmann’s spirals (bronchial asthma, can result in whorled mucous plugs)

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32
Q

Disarrrayed granulosa cells in eosinophhilic fluid

A

Call-Exner bodies (granulosa-theca cell tumor of the ovary)

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33
Q

Enlarged cells with intranuclear inclusion bodies

A

Owl’s-eye appearance of CMV

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34
Q

Enlarged thyroid cells with ground-glass nuclei

A

Orphan Annie eye nuclei of papilary carcinoma of the thyroid

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35
Q

Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia

A

Koilocytes (HPV - predisposes to cervical cancer)

36
Q

Eosinophilic cytoplasmic inclusion in liver cell

A

Mallory bodies (alcoholic liver disease)

37
Q

Eosinophilic cytoplasmic inclusion in nnerve cell

A

Lewy body (Parkinson’s disease)

38
Q

Eosinophilic globule in liver

A

Councilman body (toxic or viral hepatitis, often yellow fever)

39
Q

Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells

A

Rabies virus (Lyssavirus)

40
Q

Extracellular amyloid deposition in gray matter of brain

A

Senile plaques (Alzheimer’s disease)

41
Q

Giant B cells with bilobed nuclei with prominent inclusions (“owl’s eyes”)

A

Reed-Sternberg cells (hodgkin’s lymphoma

42
Q

Glomarulus-like structure surrounding vessels in germ cells

A

Sschiller-Duval bodies (yolk sac tumor)

43
Q

Hair-on-end’ (crew-cut0 appearance on x-ray B-thalassemia, sickle cell anemia (marrow expansion)
hCG elevated Choriocarcinoma, hydatidiform mole (with and without embryo)
Heart nodules (Granulomatous) Aschoff bodies (rheumatic fever)
Heterophile antibodies Infectious mononucleosis (EBV)
Hexagonal, double-pointed needle-like crystals in bronchial secretions Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)
High level of d-dimers DVT, pulmonary embolism, DIC
Hilar lymphadenopathy, peripheral granulomatous lesion in middle of lower lung lobes (can calcify) Ghon complex from primary tuberculosis
Honeycomb lung on x-ray interstitial fibrosis
Hypersegmented neutrophils megaloblastic anemia (B12 deficiency or folate deficiency)
Hypochromic, microcytic anemia iron deficiency anemia, lead poisoning, thalassemia (HbF sometimes present)
Increased alpha-fetoprotein in amniotic fluid/maternal serum Dating error, anencephaly, spina bifida (neural tube defects)
Increased uric acid levels Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics
Intranuclear eosinophilic droplet-like bodies Cowdry type A bodies (HSV or CMV)
Iron-containing nodules in alveolar septum Ferruginous bodie (asbestose: increases chance of developing mesothelioma)
Large lysosomal vesicles in phagocytes, immunodeficiency Chediak-Higashi disease (congenital failure of phagolysosome formation)
Lead pipe” appearance of colon on x-ray

A

Ulcerative colitis (loss of haustra)

44
Q

Linear appearance of colon on x-ray

A

Goodpasture’s syndrome

45
Q

Low serum ceruloplasmin

A

Wilson’s disease (hepatolenticular degeneration)

46
Q

Lumpy-bumpy appearance of glomeruli on immunoflourescence

A

poststreptococcal glomerulonephritis (immune complex deposition of IgG and C3b)

47
Q

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

A

Multiple myeloma

48
Q

Mammary gland (“blue-domed”) cyse

A

Fibrocystic change of the breast

49
Q

Monoclonal antibody spike (4)

A

Multiple myeloma (igA or IgG), Monoclonal gammopathy of undetermined significance (MGUS - normal with aging), Waldenstrom’s (IgM) macroglobulinemia, primary amyloidosis

50
Q

Monoclonal globulin protein in blood/urine

A

Bence Jones proteins (multiple myeloma (kappa or lambda Ig light chains in urine), or Waldenstrom’s macroglobulinemia (IgM)

51
Q

Mucin-filled cell with peripheral nucleus

A

Signet ring (gastric carcinoma)

52
Q

Narrowing of bowel lumen on barium radiograph

A

String sign (Crohn’s)

53
Q

Needle-shaped negatively birefringent crystals

A

Gout (monosodium urate crystals)

54
Q

Nodular hyaline deposits in glomeruli

A

Kimmelsetiel-Wilson nodules (DM)

55
Q

Novobiocin response

A

sensitive = Staph epidermidis; resistant = Staph saprophyticus

56
Q

Nutmeg liver

A

Chronic passive congestion of liver from RVF

57
Q

Onion skin periosteal reaction

A

Ewing’s sarcoma (malignant round cell tumor)

58
Q

Optochin response

A

Sensitive = S. pneumoniae, resistant = Viridians streptococcus

59
Q

Periostum raised from bone, creating triangluar area

A

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

60
Q

Podocyte fusion on EM

A

Minimal change disease

61
Q

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

A

Eburnation (osteoarthritis resulting in bony sclerosis)

62
Q

Protein aggregations in neurons from hyperphosphorylation of protein tau

A

Neurofibrillary tangles in Alzheimers or CJD)

63
Q

Psdudopalisading tumor cells on brain biopsy

A

Glioblastoma multiforme

64
Q

RBC cast in urine

A

Acute glomerulonephritis

65
Q

Rectangular, crystal-like cytoplasmic inclusions in Leydig cells

A

Reinke crystals (Leydig cell tumor)

66
Q

Renal epithelial casts in urine

A

Acute toxic/viral nephrosis

67
Q

Rhomboid crystals, positively birefringent

A

Pseudogout (calcium pyrophosphate dihydrate)

68
Q

Rib notching

A

Coarctation of the aorta

69
Q

Ring-enhancing lesions in Aids

A

Toxoplasma gondii

70
Q

Sheets of mdium-sized lymphoid cells (“starry sky” appearance)

A

Burkitt’s lymphoma (t[8;14] c-myc activation associated with EBV)

71
Q

Silver-staining spherical aggregation of tau proteins in neurons

A

Pick bodies (Pick’s disease: progressive dementia with changes in personality)

72
Q

Soap bubble in femur or tibia on X-ray

A

giant cell tumor of the bone (generally benign)

73
Q

Spikes on basement membrane, dome-like subepithelial deposits

A

Membranous glomerulonehritis (may progress to nephrotic syndrome)

74
Q

Stacks of RBCs

A

Rouleaux formation (high ESR, multiple myeloma)

75
Q

Stippled vaginal epithelial cells

A

clue cells - Gardnerella vaginitis

76
Q

Tennis-racket shaped cytoplasmic organelles (EM) in langerhans cells

A

Birbeck granule (histiocytosis X; eosinophilic granuloma)

77
Q

Thrombi made of white/red layers

A

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

78
Q

Thumb sign on lateral x-ray

A

Epiglottitis of H. influenzae

79
Q

Thyroid=like appearance of kidney

A

Chronic bacterial pyelonephritis

80
Q

Tram-track appearance on LM

A

membranoproliferative glomerulonephritis

81
Q

Triglyceride accumulation in liver cell vacuoles

A

fatty liver disaease (alcoholic or metabolic syndrome)

82
Q

WBCs that look smudged

A

CLL

83
Q

Wire loop glomerular appearance on LM

A

lupus nephropathy

84
Q

Yellow CSF

A

Xanthochromia (previous subarachnoid hemorrhage)

85
Q

Anti smooth-muscle antibody

A

autoimmune hepatitis