Classic findings

Question 1

High AFP in amniotic fluid or maternal serum

Answer 1

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

Question 2

Anticentromere antibodies

Answer 2

Scleroderma (CREST)

Question 3

Anti desmoglein (anti-desmosome) antibodies

Answer 3

Pemphigus vulgaris (blistering)

Question 4

Anti glomerular basement membrane antibodies

Answer 4

Goodpasteure syndrome (glomerulonephritis and haemoptysis)

Question 5

Antihistone antibodies

Answer 5

Drug-induced SLE (e.g. hydralazine, isoniazid, phenytoin, procainamide)

Question 6

Anti IgG antibodies

Answer 6

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

Question 7

Antimitochondrial antibodies (AMA)

Answer 7

Primary biliary cirrhosis (female, cholestasis, portal hypertension)

Question 8

Antineutrophil cytoplasmic antibodies (ANCA)

Answer 8

Microscopic polyangitis and eosinophilic granulomatosis with polyangiitis (MPO-ANCA/pANCA)

Granulomatosis with polyangiitis (Wegener, PR3-ANCA/ cANCA)

Primary sclerosing cholangitis (MPO-ANCA/ pANCA)

Question 9

Antinuclear antibodies (ANAs: anti-Sm & anti-dsDNA)

Answer 9

SLE (type 3 hypersensitivity)

Question 10

Antiplatelet antibodies

Answer 10

Idiopathic thrombocytopenic purpura

Question 11

Anti-topoisomerase antibodies

Answer 11

Diffuse systemic scleroderma

Question 12

Anti-transglutaminase/ anti gliadin/ anti endomysial antibodies

Answer 12

Coeliac disease (diarrhoea, weight loss)

Question 13

Apple core lesion on barium enema x-ray

Answer 13

Colorectal cancer (usually left sided)

Question 14

Atypical lymphocytes

Answer 14

EBV

Question 15

Azurophilic peroxidase positive granular inclusions in granulocytes and myeoblasts

Answer 15

Auer Rods (AML, especially the promyelocytic [M3] type)

Question 16

Bacitracin response

Answer 16

Sensitive: GAS (S.pyogenes)

Resistant: GBS (S.agalactiae)

Question 17

Bamboo spine on x-ray

Answer 17

Anykylosing spondylitis ( chronic inflammatory arthritis: HLA-B 27)

Question 18

Basophilic nuclear remnants in RBCs

Answer 18

Howell-Jolly bodies (due to splenectomy or non functional spleen)

Question 19

Basophilic stippling of RBCs

Answer 19

Lead poisoning or sideroblastic anaemia

Question 20

Bloody or yellow tap on lumbar puncture

Answer 20

Subarachnoid haemorrhage

Question 21

Boot shaped heart on x-ray

Answer 21

TOF (due to RVH)

Question 22

Branching gram-positive rods with sulphur granules

Answer 22

Actinomyces israelii

Question 23

Bronchogenic apical lung tumour on imaging

Answer 23

Pancoast tumour (can compress cervical sympathetic chain and cause Horner syndrome)

Question 24

Brown tumour of bone

Answer 24

Hyperparathyroidism or osteitis fibrosa cystica (deposited haemosiderin from haemorrhage gives brown colour)