Classic Lab Findings Flashcards
1
Q
Anti-desmoglein (epithelial) antibodies
A
Pemphigus vulgaris
2
Q
Anti-glomerular basement membrane antibodies
A
Goodpasture syndrome (glomerulonephritis and hemoptysis)
3
Q
Anti-histone antibodies
A
Drug-induced SLE
-Hydralazine, isoniazid, phenytoin, procainamide
4
Q
Anti-IgG antibodies
A
RA
-Systemic inflammation, joint pannus, boutonniere deformity)
5
Q
Antineutrophil cytoplasmic antibodies
A
Microscopic polyangiitis and eosinophilic granulomatosis w/ polyangiits (Churg-Strauss) = MPO-ANCA or p-ANCA
Granulomatosis w/ polyangiitis (PR3-ANCA or c-ANCA)
6
Q
Anti-nuclear antibodies (anti-Smith and anti-dsDNA)
A
SLE
-is a type III HSN
7
Q
Antiplatelet anibodies
A
Idiopathic thrombocytopenic purura
8
Q
Anti-topoisomerase antibodies
A
Diffuse systemic scleroderma
9
Q
Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies
A
Celiac disease
-will see diarrhea and weight loss
10
Q
“Apple core” lesion on barium enema x-ray
A
Colorectal cancer
11
Q
Atypical lymphocytes
A
EBV
12
Q
Azurophilic peroxidase (+) granular inclusions in granulocytes and myeloblasts
A
Auer rods (AML)
13
Q
Bacitracin response
A
Sensitive = S. pyogenes
Resistant = S. agalactiae
14
Q
“Bamboo spine” on x-ray
A
Ankylosing spondylitis
-Chronic inflammatory arthritis assoc. w/ HLA-B27
15
Q
Basophilic nuclear remnants in RBCs
A
Howell-Jolly bodies
-due to splenectomy or nonfunctional spleen
16
Q
Bloody or yellow tap on lumbar puncture
A
Subarachnoid hemorrhage
17
Q
Basophilic stippling of RBCs
A
Lead poisoning
or
Sideroblastic anemia
18
Q
“Boot-shaped” heart on x-ray
A
TOF
-due to RVH
19
Q
Branching Gram + rods w/ sulfur granules
A
Actinomyces israelii
20
Q
Bronchogenic apical lung tumor on imaging
A
Pancoast tumor
-Can compress cervical sympathetic chain and cause Horner Syndrome ; can also compress recurrent laryngeal nerve
21
Q
“Brown” tumor of bone
A
Hyperparathyroidism or osteitis fibrosa cystica
-Deposited hemosiderin from hemorrhage gives brown color)
22
Q
Cardiomegaly w/ apical atrophy
A
Chagas disease
23
Q
Cellular crescents in Bowman’s capsule
A
Rapidly progressive crescentic glomerulonephritis
24
Q
“Chocolate cyst” of the ovary
A
Endometriosis
-frequently involves both ovaries
25
Circular grouping of dark tumor cells surrounding pale neurofibrils
Homer-Wright rosettes
-Neuroblastoma, medulloblastoma
26
Colonies of mucoid Pseudomonas in the lungs
CF
-AR mutation in CFTR gene =>> fat-soluble vitamin deficiency and mucous plugs)
27
Decreased AFP in amniotic fluid
Down Syndrome
or other chromosomal abnormalities
28
Degeneration of dorsal column fibers
Tabes dorsalis (tertiary syphilis)
Subacute combined degeneration
-affects dorsal columns, lateral corticospinal tracty, and spinocerebellar tracts
29
"Delta wave" on EKG, short PR interval, supraventricular tachycardia
Wolf-Parkinson-White syndrome
-(bundle of KENT bypasses the AV node)
30
Degeneration of neurons in the SN
Parkinson's disease
-basal ganglia disorder; rigidity, resting tremor, bradykinesia
31
Desquamated epithelium casts in sputum
Curschmann spirals
-Bronchial asthma; can result in whorled mucous plugs
32
Disarrayed granulosa cells arranged around collections of eosinophilic fluid
Call-Exner bodies
| granulosa cell tumor of the ovary
33
Dysplastic squamous cervical cells w/ "rasanoid" nuclei and hyperchromasia
Koilocytes
| HPV; predisposes a pt. to cervical cancer
34
pgRNA
pregenomic RNA; serves 2 fnxns
1. template for HBV genome replication
2. encodes viral polymerase and HBcAg
* Has a 5' epsilon region where genome replication begins at
35
Roles of 5' epsilon region
Pol binding site
Template for DNA oligo synthesis
Encapsidation signal in assoc. w/ HBcAg
36
Cellular responses to HBV
Noncytolytic clearance: mediated by viral-specific CTL cytokines like IFNa/b, TNF-a, and IFN-y; occurs after peak of viral replication
Inflammatory mediated liver damage: High levels of CD8 and CD4 specific T-cells followed by nonspecific T-cells, NK cells, and PMNs
37
HCV infxn pathway
Interaction w/ HCV E1,E2 heterodimer w/ surface proteins such as CD-81 and SR-B1 which will form complex
SR-B1= Scavenger-receptor class B1 protein
38
Target organ in CO poisoning
Globus pallidus in the cerebellum
-CO binds to Fe2+-Hb stronger than O2 and also decreases the release of bound O2 to tissues
39
CN- poisoning
Binds to Fe3+ of mitochondrial cytochrome oxidase decreasing the fnxn of the electron transport chain
Sx: N/V, stupor, coma, convulsions, hyperventilation, heart increases then decreases, death from respiratory failure
-Survivors suffer from severe brain damage
Tx: 1. Nitrite (Converts HbFe2+ to HbFe3+ which combines w/ CN- pulling it out of the tissues
2. Thiosulfate (transfers S2- group making SCN-, a much less toxic metabolite)
3. Methylene blue (gets rid of methemeglobin) probs not on test
40
SLUD (Organophosphate poisoning)
Salivation
Lacrimation
Urination
Defecation
-Also miosis, respiratory wheezing, and (nicotinic) muscle twitch and tachycardia
Tx: Atropine (muscarinic antagonist) or pralidoxime (AchE regenerator)
*Carbaryl works the same way but AchE is reactivated in water (only give atoprine)***
41
Paraquat poisoning
Produces free radicals that lead to lipid peroxidation
Clinical: Causes SOB, pulmonary edema, pulmonary fibrosis (if chronic), Ulceration of mucous membranes, cataract formation (chronic)
Tx: Gastric lavage; hemodialysis
Diagnosis: Sodium dithionite in 2N NaOH to form a blue color confirming its presence (performed on urine)
42
Anticentromere bodies
Scleroderma (CREST)
43
Electrical alternans
Pericardial tamponade
44
Enlarged cells w/ intranuclear inclusion bodies
"Owl eye" appearance of CMV
45
Eosinophilic cytoplasmic inclusion in liver cell
Mallory body
| alcoholic liver disease
46
Eosinophilic cytoplasmic inclusion in nerve cell
Lewy Body
| Parkinson disease
47
Eosinophilic globule in the liver
Councilman body (viral hepatitis, yellow fever)
-represents hepatocyte undergoing apoptosis
48
Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar neurons
Negri bodies
-Rabies
49
Extracellular amyloid deposition in gray matter of brain
Senile plaques
-Alzheimer's disease
50
Gian B cells w/ bilobed nuclei w/ prominent inclusions (Owl's eye)
Hodgkin's lymphoma
51
Glomerulus-like structure surrounding vessel in germ cells
Schiller-Duval bodies
-Endodermal sinus tumor/Yolk-sac tumor
52
"Hair on end" (Crew-cut) appearance on x-ray
B-thalassemia, SCD
-represents extramedullary hematopoesis
53
hCG elevated
Choriocarcinoma, hydatiform mole
-Occurs w/ and w/o embryo, and multiple pregnancy
54
Heart nodules (granulomatous)
Aschoff bodies
-indicates RF
55
Heterophile antibodies
EBV (mono)
56
Hexagonal, double-pointed, needle-like crystals in bronchial secretions
Bronchial asthma (Charcot-Leiden crystals)
57
Elevated D-dimer
DVT, PE, DIC
58
Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Ghon complex
-Primary TB
59
"Honeycomb lung"
Interstitial pulmonary fibrosis
60
Hypercoaguability (leading to migrating DVTs and vasculitis)
Trousseau syndrome
-adenocarcinoma of the pancreas or lung
61
Hypersegmented PMNs
Megaloblastic anemia
B12 de =>> Neurological sx.
Folate def. =>> No neurological sx.
62
HTN, hypokalemia, metabolic alkalosis
Conn Syndrome
-Primary hyperaldosteronism
63
Hypochromic, microcytic anemia
IDE, Pb2+ poisoning, thalassemia
64
Increased AFP in amniotic fluid
Anencephaly, spina bifida
-Neural tube defects
65
Hyperuricemia
Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics
66
Intranuclear eosinophilic droplet-like bodies
Cowdry Type A bodies
HSV or VZV
67
Iron-containing nodules in alveolar septum
Ferruginous bodies
-Asbestosis; increased chance of bronchogenic carcinoma or mesothelioma
68
Keratin pearls
SCC
69
Large granules in phagocytes, immunodeficiency
Chediak-Higashi disease
-Congenital failure of phagolysosome formation
70
"Lead pipe" appearance of colon on abdominal imaging
Ulcerative colitis; occurs due to loss of haustra
71
Linear appearance of IgG deposition on glomerular and alveolar BMs
Goodpasture Syndrome
72
Decreased ceruloplasmin
Wilson's disease
-Hepatolenticular degeneration
73
"Lumpy bumpy" appearance of glomeruli on IF
PSGN
-due to deposition of IgG, IgM, and C3
74
Lytic ("punched out") bone lesions on x-ray
MM
75
Mammary gland ("Blue domed") cyst
Fibrocystic change of the breast
76
Monoclonal antibody spike
MM (usually IgG or IgA)
Monoclonal gammopathy of undetermined significance
Waldenstroms Macroglobulinemia (IgM)
Primary amyloidosis
77
Mucin-filled cell w/ peripheral nucleus
Signet ring
-Gastric carcinoma
78
Narrowing of bowel of lumen on barium x-ray
String sign
-Crohn's disease
79
Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis
Granulomatosis w/ polyangiitis (PR3-ANCA, c-ANCA pos)
Goodpasture syndrome (anti-basement membrane abs)
80
Needle-shaped, negatively birefringent crystals
Gout
-Monsodium urate crystals
81
Nodular hyaline deposits in glomeruli
Kimmelstiel-Wilson nodules
-Diabetic nephropathy
82
Novobiocin response
Sensitive = S. epidermidis
Resistant = S. saprophyticus
83
"Nutmeg" appearance of liver
RHF
or
Budd-Chiari syndrome
84
"Onion skin" periosteal reaction
Ewing sarcoma
-malignant small blue cell tumor
85
Optochin response
Sensitive= S. pneumoniae
Resistant= Strep viridans
86
Periosteum raised from bone, creating triangular area
Codman's triangle (Osteosarcoma)
Ewing sarcoma
Pyogenic osteomyelitis
87
Podocyte fusion or "effacement" on electron microscopy
MCD (MCC of childhood nephrotic syndrome)
88
Polished, ivory-like appearance of bone at cartilage erosion
Eburnation
-Osteoarthritis resulting in bony sclerosis)
89
Protein aggregates in neurons from hyperphosphorylation of tau protein
NFTs (Alzheimers)
Pick bodies (Pick's disease)
90
Psammoma bodies
Meningiomas
Papillary thyroid carcinoma
Mesothelioma
Papillary serous carcinoma of the endometrium and ovary
91
Pseudopalisading tumor cells on brain biopsy
Glioblastoma multiforme
92
RBC casts in the urine
Glomerulonephritis
93
Rectangular, crystal-like cytoplasmic inclusions of Leydig Cells
Reinke crystals
-Leydig cell tumor
94
Recurrent infxns, eczema, thrombocytopenia
Wiskott-Aldrich syndrome
95
Renal epithelial casts in urine
Intrinsic renal failure
-could be due to ischemia or toxic injury
96
Rhomboid crystals, positively birefringent
Pseudogout
-calcium pyrophosphate crystals
97
Rib notching
Aortic coarction
98
Ring-enhancing brain lesion in AIDS
Toxplasa gondii
CNS lymphoma
99
Sheets of medium-size lymphoid cells w/ scattered pale tingible body-laden macrophages ("starry sky" histology)
Burkitt's lymphoma (t[8;14])
-c-myc activation assoc. w/ EBV
100
Silver-staining spherical aggregation of tau protein in neurons
Pick bodies
-Pick disease: progressive dementia, changes in personality
101
"Soap bubble" in femur or tibia on x-ray
Giant cell tumor of the bone
102
"Spikes" on BM, "done-like" subepithelial deposits
Membranous nephropathy
103
Stacks of RBCs
Rouleux
-high ESR, MM
104
"Steeple" sign on CXR
Croup
-parainfluenza virus
105
Stippled vaginal epithelial cells
"Clue cells"
-Gardnerella vaginalis
106
Streptococcus bovus bacteremia
Colon cancer
107
"Tennis racket" shaped cytoplasmic organelles (EM) in Langerhans cells
Birbeck granules
-Langheran's cell histiocytosis
108
Thousands of polyps on colonoscopy
FAP (AD mutation of APC gene)
109
Thrombi made of white/red layers
Lines off Zahn
-arterial thrombus, layers of platelets/rbcs respectively
110
"Thumb sign" on lateral neck x-ray
Epiglottitis
-H. influenzae, could be a medical emergency
111
Thyroid-like appearance of the kidney
Chronic pyelonephritis
-usually due to recurrent infxns
112
"Tram track" appearance of capillary loops on glomerular BM on light microscopy
Membranoproliferative glomerulonephritis
113
TGL accumulation in liver cell vacuoles
Fatty liver disease
-alcoholic or metabolic syndrome
114
"Waxy" casts w/ very low urine flow
Chronic end-stage renal disease
115
WBC casts in urine
Acute pyelonephritis
116
WBCs that look "smudged"
CLL
-are always B-cells
117
"Wire loop" glomerular capillary appearance on light microscopy
Diffuse proliferative glomerulonephritis
-usually seen w/ SLE
118
Yellowish CSF
Xanthochromia
-due to SAH
119
Anti-ribonucleoprotein antibodies
Sjogren's Syndrome
anti-SSA/Ro or anti-SSB/La
120
Anti-DNA topoisomerase I
Diffuse systemic sclerosis abs
121
Anti-u1 ribonucleoprotein abs
MCTD
-Mixed features of SLE, systemic sclerosis, and polymyositis
122
PDGFB mutation
Associated w/ astrocytomas
123
KIT mutations
Assoc. w/ gastrointestinal stromal tumors
-Due to a point mutation in this stem cell growth factor receptor
124
RAS mutations
Occurs in mutations due to GTPase activating protein which normally breaks down GTP =>> GDP
-Withouth "GAP", uncontrolled activation of Ras occurs
=>>Multitude of lymphomas, melanoma, carcinomas
125
N-MYC mutations
Amplified transcription factor that can cause Neuroblastomas
126
L-MYC mutations
Amplification of the transcription factor that can result in Lung cancer
127
Li-fraumeni syndrome
Mutation in p53 leads to decreased BAX and increased Bcl-2 stability
-Develop multiple types of cancers; requires 2 hits
128
Retinoblastoma
Mutation allows constant release of E2F which constitutively activates the S-phase of the cell cycle
- Familial causes bilateral retinoblastoma AND OSTEOSARCOMA
- Requires two hits
129
GFAP stain
Stains neuroglia
130
Chromogranin stain
Stains neuroendocrine cells
-Possible to see in Small cell carinoma of the lung, carcinoid tumors, an and medulloblastoma
131
S-100 stain
Stains melanoma, schwannoma, and Langerhan's cell histiocyosis
*These are neural crest derivatives
132
Enlarged Platelets
Bernard-Soulier syndrome; GpIb deficiency =>> deficient platelet adhesion
"Big Suckers"
133
Anti-mitochondrial abs
Primary biliary cirrhosis
134
Thymoma
Tumor of thymic epitheliocytes
-Appear as multiple clear cells inside the thymus
135
Site where lymphs leave the blood stream and enter lymph nodes
Post-capillary venules
136
FTA antibodies
Confirmatory test for syphilis
137
Enfurvitide
Inhibits envelope protein gp41 from binding to CD4 cells
138
Age related Macular degeneration (dry type)
Chronic oxidative damage leads to subretinal inflammation w/ drusen deposits
-Leading cause of blindness in industrialized countries; assoc. With smoking
139
Age related macular degeneration (wet type)
Progressive ECM deposition leads to chronic hypoxia and increased angiogenesis
-Gray-green subretinal discoloration w/ small hemorrhages
140
COX-2
Only expressed at sites of inflammation; inhibited by Celecoxib
141
Carcinoid 1/3 rule
1/3 are multiple tumors
-necessary for systemic sx. due to hepatic inactivation
1/3 are in the small bowel
1/3 metastasize
1/3 have a second malignancy
142
Alveolar ventilation equation
Va= (Vt-Vd) x RR
143
Dead Space Equation
Vd= Vt x (PaCO2-PeCO2)/PaCO2
144
Decreased lung compliance examples
Pulmonary fibrosis, pneumonia, edema
145
Methemoglobinemia tx
Methylene blue
146
O2 delivery equation
O2 content X CO
O2 content= (1.34 x % saturation) + dissolved O2
-( typically ~20)
147
Causes of increased A-a gradient
Pulmonary fibrosis, COPD (diffusion mismatches)
V/Q mismatch
Shunting
Pneumonia
148
Changes in response to high altitude
Increased EPO, ventilation, 2,3-BPG, cellular mitochondria, renal HCO3 excretion, and pulmonary HTN (RVH eventually)
149
N-acetylcysteine
Mucolytic that loosens mucous plugs in CF pts by disrupting disulfide bonds
-Also used for acetaminophen OD obviously
