classic lab findings Flashcards by Al Murphy

Anticentromere antibodies

Scleroderma (CREST)

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Antidesmoglein (epithelial) antibodies

Pemphigus vulgaris (blistering)

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Anti-glomerular basement membrane antibodies

Goodpasture’s syndrome (glomerulonephritis and lung hemorrhage)

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Antihistone antibodies

Drug-induced SLE

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Anti-IgG antibodies

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

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Antimitochondrial antibodies (AMAs)

Primary biliary cirrhosis (female, cholestasis, portal hypertension)

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Antineutrophil cytoplasmic antibodies (ANCAs)

Vasculitis (Wegener’s, microscopic polyangiitis, glomerulonephritis)

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Antinuclear antibodies (ANAs: anti-Smith and anti-dsDNA)

SLE (type III hypersensitivity)

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Antiplatelet antibodies

Idiopathic thrombocytopenic purpura (ITP) (bleeding diathesis)

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Anti-topoisomerase antibodies

Diffuse systemic scleroderma

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Anti-transglutaminase/antigliadin antibodies

Celiac disease (diarrhea, distention, weight loss)

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Azurophilic granular needles in leukemic blasts

Auer rods (acute myelogenous leukemia: especially the promyelocytic type)

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“Bamboo spine” on x-ray

Ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27)

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Basophilic nuclear remnants in RBCs

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

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Basophilic stippling of RBCs

Lead poisoning or sideroblastic anemia

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Bloody tap on LP

Subarachnoid hemorrhage

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“Boot-shaped” heart on x-ray

Tetralogy of Fallot, RVH

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Branching gram-positive rods with sulfur granules

Actinomyces israelii

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Bronchogenic apical lung tumor

Pancoast’s tumor (can compress sympathetic ganglion and cause Horner’s syndrome)

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“Brown” tumor of bone

Hemorrhage (hemosiderin) causes brown color of osteolytic cysts. Due to 1. Hyperparathyroidism, 2. Osteitis fibrosa cystica

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Cardiomegaly with apical atrophy

Chagas’ disease (Trypanosoma cruzi )

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Cellular crescents in Bowman’s capsule

Rapidly progressive crescentic glomerulonephritis

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“Chocolate cyst” of ovary

Endometriosis (frequently involves both ovaries)

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Circular grouping of dark tumor cells surrounding pale neurofibrils

Homer Wright rosettes (neuroblastoma, medulloblastoma, retinoblastoma)

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Colonies of mucoid Pseudomonas in lungs

Cystic fibrosis (CFTR mutation in Caucasians resulting in fat-soluble vitamin deficiency and mucous plugs)

Degeneration of dorsal column nerves

Tabes dorsalis (Tertiary syphilis)

Depigmentation of neurons in substantia nigra

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

Desquamated epithelium casts in sputum

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

Disarrayed granulosa cells in eosinophilic fluid

Call-Exner bodies (granulosa-theca cell tumor of the ovary)

Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia

Koilocytes (HPV: predisposes to cervical cancer)

Enlarged cells with intranuclear inclusion bodies

"Owl's-eye" appearance of CMV

Enlarged thyroid cells with ground-glass nuclei

"Orphan Annie" eye nuclei (papillary carcinoma of the thyroid)

Eosinophilic cytoplasmic inclusion in liver cell

Mallory bodies (alcoholic liver disease)

Eosinophilic cytoplasmic inclusion in nerve cell

Lewy body (Parkinson's disease)

Eosinophilic globule in liver

Councilman body (toxic or viral hepatitis, often yellow fever)

Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells

Rabies virus (Lyssavirus)

Extracellular amyloid deposition in gray matter of brain

Senile plaques (Alzheimer's disease)

Giant B cells with bilobed nuclei with prominent inclusions ("owl's eye")

Reed-Sternberg cells (Hodgkin's lymphoma)

Glomerulus-like structure surrounding vessel in germ cells

Schiller-Duval bodies (yolk sac tumor)

"Hair-on-end" (crew-cut) appearance on x-ray

_-thalassemia, sickle cell anemia (extramedullary hematopoiesis)

hCG elevated

Choriocarcinoma, hydatidiform mole (occurs with and without embryo)

Heart nodules (inflammatory)

Aschoff bodies (rheumatic fever)

Heterophile antibodies

Infectious mononucleosis (EBV)

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

Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)

High level of D-dimers

DVT, pulmonary embolism, DIC

"Honeycomb lung" on x-ray

Interstitial fibrosis

Hypersegmented neutrophils

Megaloblastic anemia (B12, folate deficiency)

Hypochromic, microcytic anemia

Iron deficiency anemia, lead poisoning, thalassemia (HbF sometimes present)

Increased _-fetoprotein in amniotic fluid/ maternal serum

Anencephaly, spina bifida (neural tube defects)

Increased uric acid levels

Gout, Lesch-Nyhan syndrome, myeloproliferative disorders, loop and thiazide diuretics

Intranuclear eosinophilic droplet-like bodies

Cowdry type A bodies (HSV or yellow fever)

Iron-containing nodules in alveolar septum

Ferruginous bodies (asbestosis: _ chance of mesothelioma)

Large lysosomal vesicles in phagocytes, immunocompromised

Chediak-Higashi disease (failure of phagolysosome formation)

Low serum ceruloplasmin

Wilson's disease (hepatolenticular degeneration)

"Lumpy-bumpy" appearance of glomeruli on immunofluorescence

Poststreptococcal glomerulonephritis

Lytic ("hole-punched") bone lesions on x-ray

Multiple myeloma

Mammary gland ("blue-domed") cyst

Fibrocystic change of the breast

Monoclonal antibody spike (4) indications)

1. Multiple myeloma (called the M protein; usually IgG or IgA), 2. Monoclonal gammopahy of undetermined significance (MGUS; normal consequence of aging), 3. Waldenstrom's (M protein = IgM) macroglobulinemia, 4. Primary amyloidosis

Monoclonal globulin protein in blood/urine

Bence Jones proteins (multiple myeloma [kappa or lambda Ig light chains in urine]), Waldenstrom's macroglobulinemia (IgM)

Mucin-filled cell with peripheral nucleus

Signet ring (gastric carcinoma)

Narrowing of bowel lumen on barium radiograph

"String sign" (Crohn's disease)

Needle-shaped, negatively birefringent crystals

Gout (hyperuricemia)

Nodular hyaline deposits in glomeruli

Kimmelstiel-Wilson nodules (diabetic nephropathy)

"Nutmeg" appearance of liver

Chronic passive congestion of liver due to right heart failure

"Onion-skin" periosteal reaction

Ewing's sarcoma (malignant round-cell tumor)

Periosteum raised from bone, creating triangular area

Codman's triangle on x-ray (osteosarcoma, Ewing's sarcoma, pyogenic osteomyelitis)

Podocyte fusion on EM

Minimal change disease (child with nephrotic syndrome)

Polished, "ivory-like" appearance of bone at cartilage erosion

Eburnation (osteoarthritis resulting in bony sclerosis)

Protein aggregates in neurons from hyperphosphorylation of protein tau

Neurofibrillary tangles (Alzheimer's disease and CJD)

Pseudopalisade tumor cell arrangement

Glioblastoma multiforme

RBC casts in urine

Acute glomerulonephritis

Rectangular, crystal-like inclusions in Leydig cells

Reinke crystals (Leydig cell tumor)

Renal epithelial casts in urine

Acute toxic/viral nephrosis

Rhomboid crystals, positively birefringent

Pseudogout (calcium pyrophosphate dihydrate)

Rib notching

Coarctation of the aorta

Sheets of medium-sized lymphoid cells ("starry sky" appearance on histology)

Burkitt's lymphoma (t[8:14] c-myc activation, associated with EBV)

Silver-staining spherical aggregation of tau proteins in neurons

Pick bodies (Pick's disease: progressive dementia, similar to Alzheimer's)

Small granulomatous lesion in lungs (can calcify)

Ghon focus (Primary TB: Mycobacterium bacilli)

Small, round RBC inclusions

Heinz bodies (G6PD deficiency, _-thalassemia, chronic liver disease)

"Soap bubble" on x-ray

Giant cell tumor of bone (generally benign)

"Spikes" on basement membrane, "dome-like" endothelial deposits

Membranous glomerulonephritis (may progress to nephrotic syndrome)

Stacks of red blood cells

Rouleaux formation (high ESR: multiple myeloma)

Stippled vaginal epithelial cells

"Clue cells" (Gardnerella vaginalis)

"Tennis-racket"-shaped cytoplasmic organelles (EM) in Langerhans cells

Birbeck granules (histiocytosis X: eosinophilic granuloma)

Thrombi made of white/red layers

Lines of Zahn (arterial thrombus, layers of platelets/RBCs)

"Thumb sign" on lateral x-ray

Epiglottitis (Haemophilus influenzae)

Thyroid-like appearance of kidney

Chronic bacterial pyelonephritis

"Tram-track" appearance on LM

Membranoproliferative glomerulonephritis

Triglyceride accumulation in liver cell vacuoles

Fatty liver disease (alcoholic or metabolic syndrome)

WBCs that look "smudged"

CLL (almost always B cell; affects the elderly)

"Wire loop" glomerular appearance on LM

Lupus nephropathy

Yellow CSF

Xanthochromia (subarachnoid hemorrhage)

classic lab findings Flashcards

(92 cards)