Classic Findings/Labs Flashcards

1
Q

High AFP in amniotic fluid or maternal serum

A

Dating error

NTD

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2
Q

Anticentromere antibodies

A

Scleroderma (CREST)

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3
Q

Anti-desmoglein (anti-desmosome) antibodies

A

Pemphigus vulgaris (blistering)

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4
Q

Anti-glomerular basement membrane antibodies

A

Goodpastures syndrome (glomerulonephritis and hemoptysis)

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5
Q

Anti-histone antibodies

A

Drug-induced SLE

hydralazine, Isoniazid, phenytoin, proncainamide

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6
Q

Anti IgG antibodies

A

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

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7
Q

anti-mitochondrial antibodies (AMA)

A

Primary biliary cirrhosis (female, cholestasis, portal hypertension)

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8
Q

Antineutrophil cytoplasmic antibodies (ANCA)

A

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

Granulomatosis with polyangiitis (Wegner; PR3-ANCA/c-ANCA)

Primary sclerosing cholangitis (MPO-ANCA/p-ANCA)

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9
Q

Antinuclear antibodies (ANA)

A

SLE (type III hypersensitivity)

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10
Q

Antiplatelet antibodies

A

idiopathic thrombocytopenic purpura

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11
Q

Anti-topoisomerase antibodies

A

Diffuse systemic scleroderma

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12
Q

Anti-transglutaminase Abs
Anti-gliadin Abs
Anti-endomysial Abs

A

Celiac disease (diarrhea, weight loss)

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13
Q

Apple core lesion on barium enema X-rayu

A

Colorectal cancer (usually left-sided)

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14
Q

Atypical lymphocytes

A

EBV

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15
Q

Azurophilic peroxidase + granular inclusions in granulocytes and myeloblasts

A

Auer rods (AML, especially the promyelocytic M3 type)

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16
Q

Bacitracin response

A

Sensitive: S. pyogenes
Resistant: S. agalactiae

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17
Q

“Bamboo spine” on xray

A

Ankylosing spondylitis (chronic inflammatory arthritis HLA-B27)

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18
Q

Basophilic nuclear remnants in RBCs

A

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

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19
Q

Bloody or yellow tap on LP

A

Subarachnoid hemorrhage

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20
Q

Basophilic stippling of RBC

A

Lead poisoning or sideroblastic anemia

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21
Q

“Boot-shaped” heart on x-ray

A

Tetralogy of fallot (due to RVH)

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22
Q

Branching Gram + rods with sulfur granules

A

Actinomyces israelii

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23
Q

Bronchogenic apical lung tumor on imaging

A

Pancoast tumor

can compress cervical sympathetic chain and cause Horner syndrome

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24
Q

“Brown” tumor of bone

A

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

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25
Q

Cardiomegaly with apical atrophy

A

Chagas disease (trypanosoma cruzi)

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26
Q

Cellular crescents in Bowman’s capsule

A

Rapidly progressing crescentic glomerulonephritis

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27
Q

“Chocolate cyst” of the ovary

A

Endometriosis (frequently involved both ovaries)

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28
Q

Circular grouping of dark tumor cells surrounding pail neurofibrils

A

Homer-wright rosettes (neuroblastoma, medulloblastoma)

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29
Q

Colonies of mucoid Pseudomonas in lungs

A

Cystic fibrosis (autosomal recessive mutation in CFTR gene -> fat soluble vitamin deficiency and mucus plugs)

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30
Q

Decreased AFP in Amniotic fluid/maternal syndrome

A

Down syndrome or other chr abnl

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31
Q

Degeneration of dorsal column fibers

A
Tabes dorsalis (tertiary syphilis) or
subacute combined degeneration
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32
Q

“Delta wave” on EKG
Short PR interval
Supraventricular tachycardia

A

Wolff-Parkinson-White Syndrome (bundle of kent byasses AV node)

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33
Q

Depigmentation of neurons in substantia nigra

A

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

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34
Q

Desquamated epithelium casts in sputum

A

Curschmann spirals (bronchial asthma; can result in whorled mucous plugs)

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35
Q

Disarrayed granulosa cells arranged around collections of eosinophilic liquid

A

Call-Exner bodies (granulosa cells tumor of the ovary)

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36
Q

Dysplastic squamous cervical cells with “raisinoid” nuclei and hyperchormasia

A

Koilocytes (HPV; predisposes to cervical cancer)

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37
Q

Electrical alternans (alternating amplitude on EKG)

A

Pericardial tamponade

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38
Q

Enlarged cells with intranuclear inclusion bodies

A

“owl eye” appearance of CMV

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39
Q

Enlarged thyroid cells with ground glass nuclei with central clearing

A

“orphan annie” eyes nuclei (papillary carcinoma of the thyroid)

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40
Q

Eosinophilic cytoplasmic inclusions in liver cells

A

Mallory body (alcoholic liver disease)

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41
Q

Eosinophilic cytoplasmic inclusions in neuron

A

Lewy body (Parkinson disease and Lewy body dementia)

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42
Q

Eosinophilic globule in liver

A
Councilman body (viral hepatitis, yellow fever)
Represents hepatocyte undergoing apoptosis
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43
Q

Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar neurons

A

Negri bodies of rabies

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44
Q

Extracellular amyloid deposition in gray matter of brain

A

Alzheimer’s disease

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45
Q

Giant B cells with bi-lobed nuclei with prominent inclusions (Owl eye)

A

Reed-Sternburg cells (Hodgkin lymphoma)

46
Q

Glomerulus-like structure surrounding vessel in germ cells

A

Schiller-Duval bodies (yolk sac tumor)

47
Q

“Hair on end” (crew cut) appearance on x ray

A

Beta thalassemia
Sick cell disease
(marrow expansion)

48
Q

hCG elevated

A

Choriocarcinoma
hydatidiform mole
Multiple pregnancy

49
Q

Heart nodules (granulomatous)

A

Aschoff bodies (rheumatic fever)

50
Q

Heterophile antibodies

A

Infectious mononucleosis (EBV)

51
Q

Hexagonal, double-pointed, needle-like crystals in bronchial secretions

A

Bronchial asthma (charcot-leyden crystals; eosinophilic granules)

52
Q

High level of D-Dimbers

A

DVT, PE, DIC

53
Q

Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify)

A

Ghon complex (primary TB)

54
Q

“honeycomb lung” on x-ray or CT

A

interstitial pulmonary fibrosis

55
Q

hypercoagulability (migrating DVT and vasculitis)

A

trousseau syndrome (adenocarcinoma of pancreas or lung)

56
Q

hypersegmented neutrophils

A
Megaloblastic anemia
 (B12 deficiency: neuro symptoms)
(Folate deficiency: no neuro symptoms)
57
Q

hypertension
hypokalemia
metabolic alkalosis

A

Primary hyperaldosteronism (Conn syndrome)

58
Q

Hypochromic microcytic anemia

A

Iron deficient anemia
Lead poisoning
Thalassemia

59
Q

Intranuclear eosinophilic droplet-ilke bodies

A

Cowdry type A bodies (HSV or VZV)

60
Q

Iron-containing nodules in alveolar septum

A

Ferruginous bodies (asbestosis, increased risk of cancer)

61
Q

Keratin pearls on skin biopsy

A

Squamous cell carcinoma

62
Q

Large granules in phagocytes

Immunodeficiency

A

Chediak-Higashi disease (congenital failure of phagolysosome formation)

63
Q

“lead pipe” appearance of colon on abdominal imaging

A

Ulcerative colitis (loss of haustra)

64
Q

Linear appearance of IgG deposition on glomerular and alveolar basement membrane

A

goodpasture syndrome

65
Q

Low serum ceruloplasmin

A

Wilson disease (hepatolenticular degeneration)

66
Q

Lumpy bumpy appearance of glomeruli on immunofluorescence

A

Post-strep glomerulonephritis (due to deposition of IgG, IgM, and C3)

67
Q

Lytic “punched-out” bone lesion on x-ray

A

Multiple myeloma

68
Q

Mammary gland “blue domed” cyst

A

Fibrocystic change of the breast

69
Q

Monoclonal antibody spike

A

Multiple myeloma (IgG or IgA)
Monoclonal gammopathy of undetermined significance (MGUS, consequence of aging)
Waldenstrom (IgM)
Primary amyloidosis

70
Q

Mucin-filled cells with peripheral nucleus

A

“signet ring” of gastric carcinoma

71
Q

Narrowing of bowel lumen on barium x-ray

A

“string sign” Crohn disease

72
Q

Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis

A

Granulomatosis with polyangitis (Wegner; PR3-ANCA/c-ANCA)

Goodpasture syndrome (anti-basement membrane abs)

73
Q

Needle shaped, negative biferingent crystals

A

gout (monosodium urate crystals)

74
Q

Nodular hyaline deposits in glomeruli

A

`Kimmelstiel-Wison nodules (diabetic neuropathy)

75
Q

Novobiocin response

A

S. epidermidis (sensitive)

S. saptrophicus (resistant)

76
Q

“nutmeg” liver

A

chronic passive congestion of liver due to right sided heart failure or Budd-Chiari syndrome

77
Q

“onion skin” periosteal reaction

A

Ewing sarcoma (malignant blue cell tumor)

78
Q

Optochin sensitivity

A

S. pneumo (sensitive)

S. viridans (resistant): mutans and sanguis

79
Q

Podocyte fusion or “effacement” on electron microscopy

A

minimal change disease (child with nephrotic syndrome)

80
Q

Protein aggregates in neurons from hyperphosphorylation of tau proteins

A

neurofibrillary tangles (alzheimer’s diseae) and Pick bodies (pick disease)

81
Q

Psamomma bodies

A

Meningiomas
Papillary thyroid carcinoma
Mesothelioma
Papillary serious carcinoma (endometrium and ovary)

82
Q

Pseudopalisading tumor cells on brain biopsy

A

gioblastoma multiforme

83
Q

Raised periosteum creating a “codman triangle”

A

Aggressive bone lesion (osteosarcoma, Ewin sarcoma, osteomyelitis)

84
Q

RBC casts in the urine

A

Glomerulonephritis

85
Q

Rectangular, crystal-line, cytoplasmic inclusions in leydig cells

A

Reinke crystals (Leydig cell tumor)

86
Q

Renal epithelial casts in urine

A

Intrinsic renal failure (ischemia or toxic injury)

87
Q

Recurrent infections
eczema
Thrombocytopenia

A

Wiskott-Aldrich syndrome

88
Q

Rhomboid crystals

+ bifiringence

A

Psuedogout (calcium pyrophosphate dihydrate crystals)

89
Q

Rib notching (inferior surface) on xray

A

Coarctation of the aorta

90
Q

Ring-enhancing brain lesion on CT

A

toxoplasma gondii

CNS lymphoma

91
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

92
Q

Silver-staining spherical aggregation of tau protein in neurons

A

pick bodies (pick disease, progressive dementia, changes in personality)

93
Q

“Soap bubble” in femur or tibia on xray

A

giant cell tumor of bone

94
Q

“spikes” on basement membrane

“dome-like” subepithelial deposits

A

Membranous nephropathy (nephrotic syndrome)

95
Q

Stacks of RBC

A

Rouleaux formation (high ESR, multiple myeloma)

96
Q

“steeple” sign on frontal CXR

A

Croup (parainfluenza virus)

97
Q

Bacteria-covered vaginal epithelial cells

A

“Clue cells” Gardenella vaginalis

98
Q

Streptococcus bovis bacteremia

A

Colon cancer

99
Q

“Tennis racket”-shaped cytoplasmic organelles in langerhans cells

A

Birbeck granules (Langerhans cell histiocytosis)

100
Q

Thousands of polys on colonoscopy

A

FAP (AD mutation of APC gene)

101
Q

Thrombi made of red/white layers

A

Lines of Zahn (arterial thrombus, layers of platelets and RBC)

102
Q

“thumb sign” on lateral neck x-ray

A

Epiglottitis (Haemophilis influenzae)

103
Q

Thyroid-like appearance of kidney

A

Chronic pyelonephritis

104
Q

“Tram-track” appearance of capillary loops of glomerular basement membrane on light microscopy

A

Membranoproliferative glomerulonephritis

105
Q

Triglyceride accumulation in liver cell vacuoles

A

Fatty liver disease (alcoholic or metabolic)

106
Q

High uric acid levels

A

gout, lesch-nyhan, tumor lysis syndrome, loop and thiazide diuretics

107
Q

“waxy” casts with low urine flow

A

chronic end-stage renal disease

108
Q

WBC casts in urine

A

Acute pyelonephrtitis

109
Q

WBC that look “smudged”

A

CLL (almost always B cells)

110
Q

Wire loops glomerular capillary appearance

A

Diffuse proliferative glomerulonepthritis (seen with SLE)

111
Q

Yellowish CSF

A

Xanthochromia due to subarachnoid hemorrhage