Classic Lab/Diagnostic Findings Flashcards
1
Q
decrease AFP in amniotic fluid/maternal serum
A
down syndrome or other chromosomal abnormlaities
2
Q
large granules in phagocytes, immunodeficiency
A
Chediak-Higashi disease (congenital failure of phagolysosome formation)
3
Q
recurrent infections, eczema, thrombocytopenia
A
Wiskott-Aldrich syndrome
4
Q
branching gram + rods with sulfur granules
A
actinomyces israelii
5
Q
optochin sensitivity
A
sensitive: S. pneumoniae;
resistant: viridian’s streptococci (S mutans, S sanguis)
6
Q
novobiocin response
A
sensitive: S epidermidis
resistant: S saprophyticus
7
Q
bacitracin response
A
sensitive: S pyogenes (group A)
resistant: S agalactiae (group B)
8
Q
streptococcus bovid bacteremia
A
colon cancer
9
Q
hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobs (can calcify)
A
Ghon complex (primary TB: mycobacterium bacilli)
10
Q
bacteria-covered vaginal epithelial cells
A
‘clue cells’
gardnerella vaginalis
11
Q
ring-enhancing brain lesion on CT/MRI in AIDS
A
toxoplasma gondii
CNS lymphoma
12
Q
cardiomegaly with apical atrophy
A
Chagas disease (trypanosome cruzi)
13
Q
heterophiles antibodies
A
infectious mononucleosis (EBV)
14
Q
intranuclear eosinophilic droplet-like bodies
A
Cowdry type A bodies (HSV or VZV)
15
Q
eosinophilic globule in liver
A
councilman body (viral hepatitis, yellow fever) represents hepatocyte undergoing apoptosis
16
Q
‘steeple’ sign on frontal CXR
A
croup (parainfluenza virus)
17
Q
eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar neurons
A
Negri bodies of rabies
18
Q
atypical lymphocytes
A
EBV
19
Q
enlarged cells with intranuclear inclusion bodies
A
‘owl eye’ appearance of CMV
20
Q
‘thumb sign’ on lateral neck xray
A
epiglottitis (haemophilus influenzae)
21
Q
‘delta wave’ on EKG, short PR interval, supra ventricular tachycardia
A
Wolff-Parkinson-White syndrome (Bundle of Kent bypasses AV node)
22
Q
‘boot-shaped’ heart on xray
A
tetralogy of fallot (due to RVH)
23
Q
rib notching (inferior surface, on xray)
A
coarctation of aorta
24
Q
heart nodules (granulomatous)
A
Aschoff bodies (rheumatic fever)
25
electrical alternans (alternating amplitude on EKG)
pericardial tamponade
26
hypertension, hypokalemia, metabolic alkalosis
primary hyperaldosteronism (Conn syndrome)
27
enlarged thyroid cells with ground-glass nuclei with central clearing
"orphan Annie" eyes nuclei (papillary carcinoma of the thyroid)
28
antineutrophil cytoplasmic antibodies (ANCAs)
```
p-ANCA/MPO-ANCA = microscopic polyangiitis and eosinophilic granulomatosis with polyangiitis, primary sclerosing cholangitis
c-ANCA/PR3-ANCA = Wegener; granulomatosis with polyangiitis
```
29
mucin-filled cell with peripheral nucleus
'signet ring' (gastric carcinoma)
30
anti-transglutaminase/anti-gliadin/anti-endomysial antibodies
celiac disease (diarrhea, weight loss)
31
narrowing of bowel lumen on barium xray
'string sign' (Crohn disease)
32
'lead pipe' appearance of colon on abdominal imaging
ulcerative colitis (loss of haustra)
33
thousands of polyps on colonoscopy
familial adenomatous polyposis (autosomal dominant, mutation of APC gene)
34
'apple core' lesion on barium enema xray
colorectal cancer (usually left-sided)
35
eosinophilic cytoplasmic inclusion in liver cell
mallory body (alcoholic liver disease)
36
triglyceride accumulation in liver cell vacuoles
fatty liver disease (alcoholic or metabolic syndrome)
37
'nutmeg' appearance of liver
chronic passive congestion of liver due to right heart failure or Budd-Chiari syndrome
38
antimitochondrial antibodies (AMAs)
primary biliary cirrhosis (female, cholestasis, portal hypertension)
39
low serum ceruloplasmin
Wilson disease (hepatolenticular degeneration; Kayser-Fleischer rings d/t copper accumulation)
40
migratory thrombophlebitis (leading to migrating DVTs and vasculitis)
Trousseau syndrome (adenocarcinoma of pancreas or lung)
41
basophilic nuclear remnants in RBCs
Howell-Jolly bodies (d/t splenectomy or nonfunctional spleen)
42
hypochromic, microcytic anemia
iron deficiency anemia, lead poisoning, thalassemia (fetal hemoglobin sometimes present)
43
basophilic stippling of RBCs
lead poisoning or sideroblastic anemia
44
'hair on end' (crew-cut') appearance on xray
ß-thalassemia, sickle cell disease (marrow expansion)
45
hyperhsegmented neutrophils
megaloblastic anemia (B12 deficiency: neurologic symptoms; folate deficiency: no neurologic symptoms)
46
anti platelet antibodies
idiopathic thrombocytopenia purpura
47
high level of D-dimers
DVT, PE, DIC
48
Giant B cells with bilobed nuclei with prominent inclusions ('owl's eye')
Reed-Sternberg cells (Hodgkin lymphoma)
49
sheets of medium-sized lymphoid cells with scattered pale, tingible body-laden macrophages ('starry sky' histology)
Burkitt lymphoma (t(18;14) c-myc activation, associate with EBV, 'starry sky' made up of malignant cells)
50
lytic 'punched out' bone lesions on xray
multiple myeloma
51
monoclonal antibody spike
- multiple myeloma (usually IgG or IgA)
- monoclonal gammopathy of undetermined significance (MGUS consequence of aging)
- Waldenstrom (M protein = IgM) macroglobulinemia
- primary amyloidosis
52
stacks of RBCs
rouleaux formation (high ESR, multiple myeloma)
53
azurophilic peroxidase + granular inclusions in granulocytes and myeloblasts
Auer rods (AML, especially the promyelocytic [M3] type)
54
WBCs that look 'smudged'
CLL (almost always B cell)
55
'tennis racket' shaped cytoplasmic organelles (EM in langerhans cells
birbeck granules (langerhans cell histiocytosis)
56
'brown' tumor of bone
hyperparathyroidism or osteitis fibrosa cystica (deposits of hemosiderin from hemorrhage gives brown color)
57
raised periosteum (creating a 'codman triangle')
aggressive bone lesion (osteosarcoma, Ewing sarcoma, osteomyelitis)
58
'soap bubble' in femur or tibia on xray
giant cell tumor of bone (generally benign)
59
'onion skin' periosteal reaction
Ewing sarcoma (malignant small blue cell tumor)
60
Anti-IgG antibodies
Rheumatoid arthritis (systemic inflammation, joint pannus, boutonniere and swan neck deformities)
61
rhomboid crystals, + birefringent
psueodgout (calcium pyrophosphate dehydrate crystals)
62
needle-shaped - birefringent crystals
gout (monosodium urate crystals)
63
increase uric acid levels
gout, lesch-nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics
64
'bamboo spine' on xray
ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27)
65
antinuclear antibodies (ANAs: anti-Smith and anti-dsDNA)
SLE (type III hypersensitivity = immune complexes)
66
anti-topoisomerase antibodies
diffuse systemic scleroderma
67
keratin pearls on skin biopsy
squamous cell carcinoma
68
antihistone antibodies
drug-induced SLE (e.g. hydralazine, isoniazid, phenytoin, procainamide)
69
bloody or yellow tap on LP
SAH
70
yellowish CSF
xanthochromia (d/t SAH)
71
eosinophilic cytoplasmic inclusion in neuron
Lewy body (Parkinson disease and lewy body dementia)
72
extracellular amyloid deposition in gray matter of brain
senile plaques (Alzheimer disease)
73
depigmentation of neurons in substantia nigra
Parkinson disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia)
74
protein aggregates in neurons from hyperphosphorylation of τ protein
neurofibrillary tangles (Alzheimer disease) and Pick bodies (Pick disease)
75
silver-staining spherical aggregation of τ proteins in neurons
Pick bodies (Pick disease: progressive dementia, change in personality)
76
pseudopalisading tumor cells on brain biopsy
glioblastoma multiforme
77
circular grouping of dark tumor cells surrounding pale neurofibrils
Homer-Wright rosettes (neuroblastoma, medulloblastoma)
78
'waxy' casts with very low urine flow
chronic end stage renal disease
79
RBC casts in urine
glomerulonephritis
80
'tram-track' appearance of capillary loops of glomerular basement membranes on light microscopy
membranoproliferative glomerulonephritis
81
nodular hyaline deposits in glomeruli
Kimmelstiel-Wilson nodules (diabetic nephropathy)
82
podocyte fusion or 'effacement' on electron microscopy
minimal change disease (child with nephrotic syndrome)
83
'spikes' on basement membrane, 'dome-like' sub epithelial deposits
membranous nephropathy (nephrotic syndrome)
84
anti-glomerular basement membrane antibodies
Goodpasture syndrome (glomerulonephritis and hemoptysis)
85
cellular crescents in Bowman capsule
rapidly progressive crescentic glomerulonephritis
86
'wire loop' glomerular capillary appearance on light microscopy
diffuse proliferative glomerulonephritis (usually seen with lupus)
87
linear appearance of IgG deposition on glomerular and alveolar basement membranes
Goodpasture syndrome
88
'lumpy bumpy' appearance of glomeruli on immunofluorescence
poststreptococcal glomerulonephritis (due to deposition of IgG, IgM, and C3)
89
necrotizing vasculitis (lungs) and necrotizing glomerulonephritis
granulmatosis with polyangiitis (Wegener; PR3-ANCA/c-ANCA) and Goodpasture syndrome (anti-basement membrane antibodies)
90
thyroid-like appearance of kidney
chronic pyelonephritis (usually due to recurrent infections)
91
WBC casts in urine
acute pyelonephritis
92
renal epithelial casts in urine
intrinsic renal failure (e.g. ischemia or toxic injury)
93
ß-hCG elevated
choriocarcinoma, hydatidiform mole (occurs with and without embryo, and multiple pregnancy)
94
dysplastic squamous cervical cells with 'raisinoid' nuclei and hyperchromasia
koilocytes (HPV: predisposes to cervical cancer)
95
psammoma bodies
meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinomas of the endometrium and ovary
96
disarrayed granuloma cells arranged around collections of eosinophilic fluid
Call-Exner bodies (granuloma cell tumor of the ovary)
97
'chocolate cyst' of ovary
endometriosis (frequently involves both ovaries)
98
mammary gland ('blue domed') cyst
fibrocystic change of the breast
99
glomerulus-like structure surrounding vessel in germ cells
Schiller-Duval bodies (yolk sac tumor)
100
rectangular, crystal-like, cytoplasmic inclusions in Leydig cells
Reinke crystals (Leydig cell tumor)
101
thrombi made of white/red layers
lines of Zahn (arterial thrombus, layers of platelets/RBCs)
102
hexagonal, double-pointed, needle-like crystals in bronchial secretions
bronchial asthma (Charcot-leyden crystals: eosinophilic granules)
103
desquamated epithelium casts in sputum
curschmann spirals (bronchial asthma, can result in whorled mucous plugs)
104
'honeycomb lung' on xray or CT
interstitial pulmonary fibrosis
105
colonies of mucoid Pseudomonas in lungs
cystic fibrosis (autosomal recessive mutation in CFTR gene -> fat-soluble vitamin deficiency and mucous plug)
106
iron-containing nodules in alveolar septum
ferruginous bodies (asbestosis: increase chance of lung cancer)
107
bronchogenic apical lung tumor on imaging
Pancoast tumor (can compress cervical sympathetic chain and cause Horner syndrome)
