Classic Findings/Labs Flashcards
(111 cards)
1
Q
AFP in amniotic uid/maternal serum
A
Dating error, anencephaly, spina bi da (neural tube defects)
2
Q
Anticentromere antibodies
A
Scleroderma (CREST)
3
Q
Anti-desmoglein (anti-desmosome) antibodies
A
Pemphigus vulgaris (blistering)
4
Q
Anti–glomerular basement membrane antibodies
A
Goodpasture syndrome (glomerulonephritis and hemoptysis)
5
Q
Antihistone antibodies
A
Drug-induced SLE (eg, hydralazine, isoniazid, phenytoin, procainamide)
6
Q
Anti-IgG antibodies
A
Rheumatoid arthritis (systemic in ammation, joint pannus, boutonnière deformity)
7
Q
Antimitochondrial antibodies (AMAs)
A
1° biliary cirrhosis (female, cholestasis, portal hypertension)
8
Q
Antineutrophil cytoplasmic antibodies (ANCAs)
A
SLE (type III hypersensitivity)
9
Q
Antiplatelet antibodies
A
Idiopathic thrombocytopenic purpura
10
Q
Anti-topoisomerase antibodies
A
Diffuse systemic scleroderma
11
Q
Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies
A
Celiac disease (diarrhea, weight loss)
12
Q
“Apple core” lesion on barium enema x-ray
A
Colorectal cancer (usually left-sided)
13
Q
Azurophilic peroxidase ⊕ granular inclusions in granulocytes and myeloblasts
A
Auer rods (AML, especially the promyelocytic [M3] type)
14
Q
Bacitracin response
A
Sensitive: S pyogenes (group A); resistant: S agalactiae (group B)
15
Q
“Bamboo spine” on x-ray
A
Ankylosing spondylitis (chronic in ammatory arthritis: HLA-B27)
16
Q
Basophilic nuclear remnants in RBCs
A
Howell-Jolly bodies (due to splenectomy or nonfunctional spleen)
17
Q
Basophilic stippling of RBCs
A
Lead poisoning or sideroblastic anemia
18
Q
Bloody or yellow tap on lumbar puncture
A
Subarachnoid hemorrhage
19
Q
“Boot-shaped” heart on x-ray
A
Tetralogy of Fallot (due to RVH)
20
Q
Branching gram ⊕ rods with sulfur granules
A
Actinomyces israelii
21
Q
Bronchogenic apical lung tumor on imaging
A
Pancoast tumor (can compress cervical sympathetic chain and cause Horner syndrome)
22
Q
“Brown” tumor of bone
A
Hyperparathyroidism or osteitis brosa 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 crescentic glomerulonephritis
25
“Chocolate cyst” of ovary
Endometriosis (frequently involves both ovaries)
26
Circular grouping of dark tumor cells surrounding pale neurofibrils
Homer-Wright rosettes (neuroblastoma, medulloblastoma)
27
Colonies of mucoid Pseudomonas in lungs
Cystic fibrosis (autosomal recessive mutation in CFTR gene fat-soluble vitamin deficiency and mucous plugs)
28
AFP in amniotic fluid/maternal serum
Down syndrome or other chromosomal abnormalities
29
Degeneration of dorsal column fibers
```
Tabes dorsalis (3° syphilis), subacute combined degeneration (dorsal columns, lateral corticospinal, spinocerebellar tracts
affected)
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30
“Delta wave” on EKG, short PR interval, supraventricular tachycardia
Wolff-Parkinson-White syndrome (Bundle of Kent bypasses AV node)
31
Depigmentation of neurons in substantia nigra
Parkinson disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia)
32
Desquamated epithelium casts in sputum
Curschmann spirals (bronchial asthma; can result in whorled mucous plugs)
33
Disarrayed granulosa cells arranged around collections of eosinophilic fluid
Call-Exner bodies (granulosa cell tumor of the ovary)
34
Dysplastic squamous cervical cells with “raisinoid” nuclei and hyperchromasia
Koilocytes (HPV: predisposes to cervical cancer)
35
Electrical alternans (alternating amplitude on EKG)
Pericardial tamponade
36
Enlarged cells with intranuclear inclusion bodies
“Owl eye” appearance of CMV
37
Enlarged thyroid cells with ground-glass nuclei with central clearing
“Orphan Annie” eyes nuclei (papillary carcinoma of the thyroid)
38
Eosinophilic cytoplasmic inclusion in liver cell
Mallory body (alcoholic liver disease)
39
Eosinophilic cytoplasmic inclusion in neuron
Lewy body (Parkinson disease and Lewy body dementia)
40
Eosinophilic globule in liver
Councilman body (viral hepatitis, yellow fever), represents hepatocyte undergoing apoptosis
41
Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar neurons
Negri bodies of rabies
42
Extracellular amyloid deposition in gray matter of brain
Senile plaques (Alzheimer disease)
43
Giant B cells with bilobed nuclei with prominent inclusions (“owl’s eye”)
Reed-Sternberg cells (Hodgkin lymphoma
44
Glomerulus-like structure surrounding vessel in germ cells
Schiller-Duval bodies (yolk sac tumor)
45
“Hair on end” (“Crew-cut”) appearance on x-ray
β-thalassemia, sickle cell disease (marrow expansion)
46
hCG elevated
Choriocarcinoma, hydatidiform mole (occurs with and without embryo, and multiple pregnancy)
47
Heart nodules (granulomatous)
Aschoff bodies (rheumatic fever)
48
Heterophile antibodies
Infectious mononucleosis (EBV)
49
Hexagonal, double-pointed, needle-like crystals in bronchial secretions
Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)
50
High level of d-dimers
DVT, PE, DIC
51
Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Ghon complex (1° TB: Mycobacterium bacilli)
52
“Honeycomb lung” on x-ray or CT
Interstitial pulmonary fibrosis
53
Hypercoagulability (leading to migrating DVTs and vasculitis)
Trousseau syndrome (adenocarcinoma of pancreas or lung)
54
Hypersegmented neutrophils
Megaloblastic anemia (B12 de ciency: neurologic symptoms; folate de ciency: no neurologic symptoms)
55
Hypertension, hypokalemia, metabolic alkalosis
1° hyperaldosteronism (Conn syndrome)
56
Hypochromic, microcytic anemia
Iron deficiency anemia, lead poisoning, thalassemia (fetal hemoglobin sometimes present)
57
Intranuclear eosinophilic droplet-like bodies
Cowdry type A bodies (HSV or VZV)
58
Iron-containing nodules in alveolar septum
Ferruginous bodies (asbestosis: chance of mesothelioma)
59
Keratin pearls on a skin biopsy
Squamous cell carcinoma
60
Large granules in phagocytes, immunode ciency
Chédiak-Higashi disease (congenital failure of phagolysosome formation)
61
“Lead pipe” appearance of colon on abdominal imaging
Ulcerative colitis (loss of haustra)
62
Linear appearance of IgG deposition on glomerular and alveolar basement membranes
Goodpasture syndrome
63
Low serum ceruloplasmin
Wilson disease (hepatolenticular degeneration)
64
“Lumpy bumpy” appearance of glomeruli on immunofluorescence
Poststreptococcal glomerulonephritis (due to deposition of IgG, IgM, and C3)
65
Lytic (“punched-out”) bone lesions on x-ray
Multiple myeloma
66
Mammary gland (“blue domed”) cyst
Fibrocystic change of the breast
67
Mammary gland (“blue domed”) cyst
Fibrocystic change of the breast
68
Monoclonal antibody spike
```
Multiple myeloma (usually IgG or IgA);
Monoclonal gammopathy of undetermined significance (MGUS consequence of aging);
Waldenström (M protein = IgM) macroglobulinemia;
Primary amyloidosis
```
69
Mucin- filled cell with peripheral nucleus
“Signet ring” (gastric carcinoma)
70
Narrowing of bowel lumen on barium x-ray
“String sign” (Crohn disease)
71
Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis
Granulomatosis with polyangiitis (Wegener; PR3-ANCA/c-ANCA) and Goodpasture syndrome (anti–basement
membrane antibodies)
72
Needle-shaped, ⊝ birefringent crystals
Gout (monosodium urate crystals)
73
Nodular hyaline deposits in glomeruli
Kimmelstiel-Wilson nodules (diabetic nephropathy)
74
Novobiocin response
Sensitive: S epidermidis; resistant: S saprophyticus
75
“Nutmeg” appearance of liver
Chronic passive congestion of liver due to right heart failure or Budd-Chiari syndrome
76
“Onion skin” periosteal reaction
Ewing sarcoma (malignant small blue cell tumor)
77
Optochin response
Sensitive: S pneumoniae; resistant: viridans streptococci (S mutans, S sanguis)
78
Podocyte fusion or “effacement” on electron microscopy
Minimal change disease (child with nephrotic syndrome)
79
Polished, “ivory-like” appearance of bone at cartilage erosion
Eburnation (osteoarthritis resulting in bony sclerosis)
80
Protein aggregates in neurons from hyperphosphorylation of tau protein
Neuro brillary tangles (Alzheimer disease) 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
83
Raised periosteum (creating a “Codman triangle”)
Aggressive bone lesion (eg, osteosarcoma, Ewing sarcoma, osteomyelitis)
84
RBC casts in urine
Glomerulonephritis
85
Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells
Reinke crystals (Leydig cell tumor)
86
Recurrent infections, eczema, thrombocytopenia
Wiskott-Aldrich syndrome
87
Renal epithelial casts in urine
Intrinsic renal failure (eg, ischemia or toxic injury)
88
Rhomboid crystals, ⊕ birefringent
Pseudogout (calcium pyrophosphate dihydrate crystals)
89
Rib notching (inferior surface, on x-ray)
Coarctation of the aorta
90
Ring-enhancing brain lesion on CT/MRI in AIDS
Toxoplasma gondii, CNS lymphoma
91
Sheets of medium-sized lymphoid cells with scattered pale, tingible body–laden macrophages (“starry sky” histology)
Burkitt lymphoma (t[8:14] c-myc activation, associated with EBV; “starry sky” made up of malignant cells)
92
Silver-staining spherical aggregation of tau proteins in neurons
Pick bodies (Pick disease: progressive dementia, changes in personality)
93
“Soap bubble” in femur or tibia on x-ray
Giant cell tumor of bone (generally benign)
94
“Spikes” on basement membrane, “dome-like” subepithelial deposits
Membranous nephropathy (nephrotic syndrome)
95
Stacks of RBCs
Rouleaux formation (high ESR, multiple myeloma)
96
“Steeple” sign on frontal CXR
Croup (parainfluenza virus)
97
Stippled vaginal epithelial cells
“Clue cells” (Gardnerella vaginalis)
98
Streptococcus bovis bacteremia
Colon cancer
99
“Tennis racket”-shaped cytoplasmic organelles (EM) in Langerhans cells
Birbeck granules (Langerhans cell histiocytosis)
100
Thousands of polyps on colonoscopy
Familial adenomatous polyposis (autosomal dominant, mutation of APC gene)
101
Thrombi made of white/red layers
Lines of Zahn (arterial thrombus, layers of platelets/RBCs)
102
“Thumb sign” on lateral neck x-ray
Epiglottitis (Haemophilus in uenzae)
103
Thyroid-like appearance of kidney
Chronic pyelonephritis (usually due to recurrent infections)
104
“Tram-track” appearance of capillary loops of glomerular basement membranes on light microscopy
Membranoproliferative glomerulonephritis
105
Triglyceride accumulation in liver cell vacuoles
Fatty liver disease (alcoholic or metabolic syndrome)
106
uric acid levels
Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics
107
“Waxy” casts with very low urine ow
Chronic end-stage renal disease
108
WBC casts in urine
Acute pyelonephritis
109
WBCs that look “smudged”
CLL (almost always B cell)
110
"Wire loop” glomerular capillary appearance on light microscopy
Diffuse proliferative glomerulonephritis (usually seen with lupus)
111
Yellowish CSF
Xanthochromia (eg, due to subarachnoid hemorrhage)s
