Classic Lab/Findings Flashcards
1
Q
Anticentromere antibodies
A
Scleroderma (CREST)
2
Q
Antidesmoglein (epithelial) antibodies
A
Pemphigus vulgaris (blistering)
3
Q
Anti-glomerular basement membrane antibodies
A
Goodpasture’s syndrome (glomerulonephritis and hemoptysis)
4
Q
Antihistone antibodies
A
Drug-induced SLE (hyrdalazine, isoniazid, phenytoin, procainamide, sulfa drugs, etanercept)
5
Q
Anti-IgG antibodies
A
Rheumatoid Arthritis (systemic inflammation, joint pannus, boutonniere deformity)
6
Q
Antimitochondrial antibodies (AMAs)
A
Primary biliary cirrhosis (female, cholestasis, portal hypertension)
7
Q
Antineutrophil cytoplasmic antibodies (ANCAs)
A
Vasculitis
- c-ANCA: granulomatosis with polyangiitis [Wegener’s];
- p-ANCA: microscopic polyangiitis, Churg-Strauss syndrome
8
Q
Antinuclear antibodies
A
Idiopathic thrombocytopenic purpura (ITP)
SLE (sensitive but not specific)
9
Q
Anti-topoisomerase antibodies
A
Systemic -> Diffuse -> sclerdoderma
10
Q
Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies
A
Celiac disease (diarrhea, distention, weight loss)
11
Q
“Apple core” lesion on abdominal x-ray
A
Colorectal cancer (usually left-sided)
12
Q
Axurophilic peroxidase-positive granular inclusions in granulocytes and myeloblasts
A
Auer rods (acute myelogenous leukemia, especially the promyelocytic [M3] type)
13
Q
Bacitracin response
A
Sensitive: Streptococcus pyogenes (group A);
resistant: Streptococcus agalactiae (group B)
14
Q
“Bamboo spine” on x-ray
A
Ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27)
15
Q
Basophilic nuclear remnants in RBCs
A
Howell-Jolly bodies (due to splenectomy or nonfunctional spleen)
16
Q
Basophilic stippling of RBCs
A
Thalassemias
Anemia of Chronic Disease
Lead Poisoning
17
Q
Bloody tap on LP
A
Subarachnoid hemorrhage
18
Q
“Boot shaped” heart on x-ray
A
Tetralogy of Fallot, RVH
19
Q
Branching gram-positive rods with sulfur granules
A
Actinomyces israelii
20
Q
Bronchogenic apical lung tumor on imaging
A
Pancoast tumor (can compress sympathetic ganglion and cause Horner’s syndrome)
21
Q
“Brown” tumor of bone
A
Hyperparathyroidism or osteitis fibrosa cystica (deposited hemosiderin from hemorrhage gives brown color)
22
Q
Cardiomegaly with apical atrophy
A
Chagas’ disease (Trypanosoma cruzi)
23
Q
Cellular crescents in Bowman’s capsule
A
Rapidly progressive crescentic glomerulonephritis
24
Q
“Chocolate cyst” of ovary
A
Endometriosis (frequently involves both ovaries)
25
Circular grouping of dark tumor cells surrounding pale neurofibrils
Homer-Wright rosettes (neuroblastoma, medullosblastoma, retinoblastoma)
26
Colonies of mucoid Pseudomonas in lungs
Cystic fibrosis (autosomal-recessive mutation in CFTR resulting in fat-soluble vitamin deficiency and mucous plugs)
27
Decreased alpha-fetoprotein in amniotic fluid/maternal serum
Down syndrome, Edward's
Note: ↑α-FP in Neural Tube Defects
28
Degeneration of dorsal column nerves
Tabes dorsalis (Tertiary syphilis)
Subacute combined degenration (dorsal column and lateral corticospinal tracts affected) - VitB12 or Vit E deficiency
29
Depigmentation of neurons in substantia nigra
Parkinson's disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia)
30
Desquamated epithelium casts in sputum
Curschmann's spirals (bronchial asthma; can result in whorled mucous plugs)
31
Disarrayed granulosa cells in eosinophilic fluid
Call-Exner bodies (granulosa-theca cell tumor of the ovary)
32
Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia
Koilocytes (HPV: predisposes to cervical cancer)
33
Enlarged cells with intranuclear inclusion bodies
"Owl's eye" appearence of CMV
34
Enlarged thyroid cells with ground-glass nuclei
"Orphan Annie's eyes" nuclei (papillary carcinoma of the thyroid)
35
Eosinophilic cytoplasmic inclusion in liver cell
Mallory bodies (alcoholic liver disease)
36
Eosinophilic cytoplasmic inclusion in nerve cell
Lewy body (Parkinson's disease)
37
Eosinophilic globule in liver
Councilman body (toxic or viral hepatitis, often yellow fever)
38
Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells
Negri bodies of rabies (Lyssavirus)
39
Extracellular amyloid deposition in gray matter of brain
Senile plaques (Alzheimer's disease)
40
Giant B cells with bilobed nuclei with prominent inclusions ("owl's eye")
Reed-Sternberg cells (Hodgkin's lymphoma)
41
Glomerulus-like structure surrounding vessel in germ cells
Schiller-Duval bodies (yolk sac tumor)
42
"Hair on end" (crew-cut) appearance on x-ray
Beta-thalassemia, sickle cell anemia (marrow expansion)
43
hCG elevated
Choriocarcinoma, hydatidiform mole (occurs with and without embryo)
44
Heart nodules (granulomatous)
Aschoff bodies (rheumatic fever)
45
Heterophile antibodies
Infectious mononucleosis (EBV)
46
Hexagonal, double-pointed, needle-like crystals in bronchial secretions
Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)
47
High levels of D-dimers
DVT, pulmonary embolism, DIC
48
Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Ghon complex (Primary TB: Mycobacterium bacilli)
49
"Honeycomb lung" on x-ray or CT
Interstitial pulmonary fibrosis
50
Hypercoagulability (leading to migrating DVTs and vasculitis)
Trousseau's syndrome (adenocarcinoma of pancreas or lung)
Note: Trousseau's sign: occlusion of brachial artery with BP cuff -> carpal spasm
51
Hypersegmented neutrophils
Megaloblastic anemia (B12 deficiency: neurologic symptoms; folate deficiency: no neurologic symptoms)
52
Hypertension, hypokalemia, metabolic alkalosis
Primary Hyperaldosteronism (Conn's syndrome)
53
Hypochromic, microcytic anemia
Iron deficiency anemia, sideroblastic anemia, lead poisioning, thalassemia (fetal hemoglobin sometimes present)
54
Increase alpha-fetoprotein in amniotic fluid/maternal serum
Dating error, anencephaly, spina bifida (neural tube defects)
55
Increased uric acid levels
Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics
56
Intranuclear eosinophilic droplet-like bodies
Bowdry type A Bodies (HSV or CMV)
57
Iron-containing nodules in alveolar septum
Ferruginous bodies (asbestosis: increased chance of mesothelioma)
58
Keratin pearls on a skin biospy
Squamous cell carcinoma
59
Large lysosomal vesicles in phagocytes, immunodeficiency
Chediak-Higashi disease (congenital failure of phagolysosome formation)
60
"Lead pipe" appearence of colon on barium enema x-ray
Ulcerative colitis (loss of haustra)
61
Linear appearence of IgG deposition on glomerular basement membrane
Goodpasture's syndrome
62
Low serum ceruloplasmin
Wilson's disease (hepatolenticular degeneration)
63
"Lumpy bumpy" appearence of glomeruli on immunofluorescence
Poststreptococcal glomerulonephritis (immune complex deposition of IgC and C3b)
64
Lytic ("hole punched") bone lesions on x-ray
Multiple myeloma
65
Mammary gland ("blue domed") cyst
Fibrocystic change of the breast
66
Monoclonal antibody spike
- Multiple myeloma (usually IgG or IgA)
- Monoclonal gammopathy of undeterminded significance (MGUS; normal consequence of aging)
- Waldenstrom's (M protein = IgM) macroglobulinemia
- Primary amyloidosis
67
Mucin-filled cell with peripheral nucleus
Signet ring (gastric carcinoma)
68
Narrowing of bowel lumen on barium x-ray
"String sign" (Crohn's disease)
69
Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis
Granulomatosis with polyangiitis (Wegener's; c-ANCA positive) and Goodpasture's syndrome (anti-basement membrane antibodies)
70
Needle-shaped, negatively birefringent crystals
Gout (monosodium urate crystals)
71
Nodular hyaline deposits in glomeruli
Kimmelstiel-Wilson nodules (diabetic nephropathy)
72
Novobiocin response
Sensitive: Staphylococcus epidermidis; resistant: Staphylococcus saprophyticus
73
"Nutmeg" appearance of liver
Chronic passive congestion of liver due to right heart failure
74
"Onion skin" periosteal reaction
Ewing's sarcoma (malignant round-cell tumor)
75
Optochin response
Sensitive: Streptococcus pneumoniae; resistant: Viridans streptococcus
76
Periosteum raised from bone, creating triangular area
Codman's triangle on x-ray (osteosarcoma, Ewing's sarcoma, pyogenic osteomyelitis)
77
Podocyte fusion or "effacement" on election microscopy
Minimal change disease (child with nephrotic syndrome)
FSGS
78
Polished, "ivory like" appearence of bone at cartilage erosion
Eburnation (osteoarthritis resulting in bony sclerosis)
79
Protein aggregates in neurons from hyperphosphorylation of protein tau
Neurofibrillary tangles (Alzheimer's disease) and Pick's bodies (Pick's disease)
80
Psammoma bodies
Meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of the endometrium and ovary
81
Pseudopalisading tumor cells on brain biopsy
Glioblastoma multiforme
82
RBC casts in urine
Acute glomerulonephritis
83
Rectangular, crystal-like, cystoplasmic inclusions in Leydig cells
Reinke crystals (Leydig cell tumor)
84
Renal epithelial casts in urine
Acute toxic/viral nephrosis
85
Rhomboid crystals, weakly positively birefringent
Pseudogout (calcium pyrophosphate dihydrate crystals)
86
Rib notching
Coarctation of the aorta
87
Ring-enhancing brain lesion in AIDS
Toxoplasma gondii, CNS lymphoma
88
Sheets of medium-sized lymphoid cells with scattered pale, tingible body-laden macrophages ("starry sky" histology)
Burkitt's lymphoma (t[8:14] c-myc activation, associated with EBV; "black sky" made of malignant cells)
89
Silver-staining spherical aggregation of tau proteins in neurons
PIck bodies (Pick's disease: progressive dementia, changes in personality)
90
"Soap bubble" in femur or tibia on x-ray
Giant cell tumor of bone (generally benign)
91
"Spikes" on basement membrane, "dome like" subepithelial deposits
Membranous glomerulonephritis (may progress to nephrotic syndrome)
92
Stacks of RBCs
Rouleaux formation (high ESR, multiple myeloma)
93
Stippled vaginal epithelial cells
"Clue cells" (Gardnerella vaginalis)
94
"Tennis racket" shaped cytoplasmic organelles (EM) in Langerhans cells
Birbeck granules (Langerhans cell histiocytosis or histiocytosis X: eosinophilic granuloma)
95
Thrombi made of white/red layers
Lines of Zahn (arterial thrombus, layers of platelets/RBCs)
96
"Thumb sign" on lateral x-ray
Epiglottitis (Haemophilus influenzae)
97
Thyroid-like appearance of kidney
Chronic bacterial pyelonephritis
98
Tram-track appearance of capillary loops of glomerular basement membranes on light microscopy
Membranoproliferative glomerulonephritis
99
Triglyceride accumulation in liver cell vacuoles
Fatty liver disease (alcoholic or metabolic syndrome)
100
"Waxy" casts with very low urine flow
Chronic end-stage renal disease
101
WBC casts in urine
Acute pyelonephritis
102
WBCs that look "smudged"
CLL (almost always B-cell)
103
"Wire loop" glomerular capillary appearance on light microscopy
Lupus nephropathy
104
Yellowish/Bloody CSF on spinal tap
Xanthochromia (e.g., due to subarachnoid hemorrhage)
