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Flashcards in Classic Labs- Diagnosis Deck (105):
1

Anticentromere antibodies

Scleroderma (CREST)

2

Antidesmoglein (epithelial) antibodies

Pemphigus vulgaris (blistering)

3

Anti-glomerular basement membrane antibodies

Goodpasture syndrome (glomerulonephritis and hemoptysis)

4

Antihistone antibodies

Drug-induced SLE (hydralazine, INH, phenytoin, procainaminde)

5

Anti-IgG antibodies

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

6

Antimitochondrial antibodies (AMAs)

primary biliary cirrhosis ( female, cholestasis, portal hypertension)

7

Antineutrophile cytoplasmic antibodies (ANCAs)

Microscopic polyangiitis and Churg-Strauss syndrome (MPO-ANCA/p-ANCA); granulomatosis with polyangiitis (Wegner; PR3-ANCA/c-ANCA)

8

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

SLE ( type III hypersensitivity)

9

Antiplatelet antibodies

Idiopathic thrombocytopenic purpura

10

Anti-topoisomerase antibodies

Diffuse systemic scleroderma

11

Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies

Celiac disease (diarrhea, distention,weight loss)

12

"Apple core" lesion on abdominal x-ray

Colorectal cancer (usually left-sided)

13

Azurophilic peroxidase + granular inclusions in granulocytes and myeloblasts

Auer rods (AML, especially the promyelocytic [M3] type)

14

Bacitracin response

Sensitive: Strep pyogenes (group A); Resistant: Strep agalactiae (group B)

15

"bambo spine" on x-ray

Ankylosing spondylitis ( chronic inflammatory arthritis: HLA-B27)

16

Basophilic nuclear remnants in RBCs

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

17

Basophilic strippling of RBC's

Lead poisoning or sideroblastic anemia

18

Bloody tap on LP

subarachnoid hemorrhage

19

"Boot-shaped" heart on X-ray

Tetralogy of Fallot, RVH

20

Branching gram-positive rods with sulfur granules

Actinomyces israelii

21

Bronchogenic apical lung tumor on imaging

Pancoast tumor ( can compress smpathetic ganglion and cause Horner syndrome)

22

"Brown" tumor of bone

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

23

Cardiomegaly with apical atrophy

Chagas disease( Trypanosoma cruzi)

24

Cellular crescent in Bowman capsule

Rapidly progressive crescentic glomerulonephritis

25

"Chocolate cyst" of ovary

Endometriosis (frequently involves both ovaries)

26

Circular grouping of dark tumor cells surrounding pale neurofibrils

Homer-Wright Rosettes (neuroblastoma, medulloblastoma reintoblastoma)

27

Colonies of mucoid Pseudomonas in lungs

Cystic fibrosis ( autosomal recessive mutation in CFTR gene leads to fat-soluble vitamin deficiency and mucous plugs)

28

decreased AFP in amniotic fluid/maternal serum

Down syndrome or other chromosomal abnormailty

29

Degeneration of dorsal column nerves

Tabes dorsalis ( 3 syphilis), subacute combined degeneration( dorasl columns and lateral corticospinal tracts affected)

30

Depigmentation of neurons in substantia nigra

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

31

Desquamated epithelium cast in sputum

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

32

Disarrayed granulosa cells in eosinophilic fluid

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

33

Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia

Koilocytes (HPV: predisposes to cervical cancer)

34

Enlarge cells with intranuclear inclusion bodies

"Owl eye" appearance of CMV

35

Enlarged thyroid cells with ground class nuclei

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

36

Eosinophilic cytoplasmic inclusion in liver cells

Mallory body (alcoholic liver disease)

37

Eosinophilic cytoplasmic inclusion in nerve cell

Lewy body ( Parkinson disease)

38

Eosinophilic globule in liver

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

39

Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar nerve cells

Negri bodies of rabies

40

Extracellular amyloid deposition in gray matter of brain

Senile plaques ( Alzheimer disease)

41

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

Reed-Sternberg cells (Hodgkin lymphoma)

42

Glomerulus-like structure surrounding vessel of germ cells

Schiller-Duval bodies (yolk sac tumor)

43

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

B-thalassemia, sickle cell anemia (marrow expansion)

44

hCG elevated

Choriocarcinoma, hydatidiform mole(occurs with and without embryo, and multiple pregnancy)

45

Heart nodules (granulomatous)

Aschoff bodies (rheumatic fever)

46

Heterophile antibodies

Infectious mononucleosis (EBV)

47

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

Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)

48

High level of D-dimers

DVT, PE, DIC

49

Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes

Ghon complex ( 1 TB: Mycobacterium bacilli)

50

"honeycomb lung" on x-ray or CT

Interstitial pulmonary fibrosis

51

Hypercoagulability ( leading to migrating DVT's and vasculitis)

Trousseau syndrome ( adenocarcinoma of pancrease or lung)

52

hypersegmented neutrophils

Megaloblastic anemia (B12 deficiency: neurologic symptoms: folate deficiency: no neurologic symptoms)

53

Hypertension, hypokalemia, metabolic alkalosis

Conn syndrome

54

Hypochromic, microcytic anemia

Iron deficiency anemia, lead poisoning, thalassemia

55

Increased AFP in amniotic fluid/maternal serum

Dating error, anencephaly, spina bifida (neural tube defects)

56

Increased uric acid levels

Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diurectics

57

Intranuclear eosinophilic droplet-like bodies

Cowdry type A bodies (HSV or CMV)

58

Iron-containing nodules in alveolar septum

Ferruginous bodies (asbesosis: increased chance of mesothelioma)

59

Keratin pearls on a skin biopsy

squamous cell carcinoma

60

Large lysosomal vesicles in phagocytes, immunodeficiency

Chediak-Higashi disease ( congenital failure of phagolysome formation)

61

"Lead pipe" appearance of colon on barium enema x-ray

Ulcerative colitis (loss of haustra)

62

Linear appearance of IgG deposition on glomerular basement membrane

Goodpasture syndrome

63

Low serum ceruloplasmin

Wilson disease ( hepatolenticular degeneration)

64

"lumpy bumpy appearance of glomeruli on immunofluorescence

Poststreptococcal glomerulonphritis ( immune complex deposition of IgG and C3B

65

Lytic "hole punched" bone lesions on x-ray

Multiple myeloma

66

Mammary gland ( "blue domed") cyst

Fibrocystic change of the breast

67

Monoclonal antibody spike

-multiple myeloma ( usually IgG or IgA)
-Monoclonal gammopathy of undetermined significance ( MGUS consequence of again)
-waldenstrom ( M protein = IgM) macroglobulinemia
-Primary amyloidosis

68

Mucin-filled cell with peripheral nucleus

"signet ring" (gastric carcinoma)

69

Narrowing of bowel lumen on barium x-ray

"string sign" (crohn disease)

70

Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis

Granulomatosis with polyangiitis ( Wegener; PR3-ANCA/c-ANCA) and Goodpasture syndrome (anti-basement membrane antibodies)

71

needle-shaped, negatively birefringent crystals

Gout ( monosodium urate crystals)

72

Nodular hyaline deposits in glomeruli

Kimmelstiel-Wilson nodules (diabetic nephropathy)

73

Novobiocin response

Sensitive: Staph epidermidis
Resistant: Staph saprophyticus

74

"nutmeg" appearance of liver

Chronic passive congestion of liver due to right heart failure

75

"onion skin" periosteal reaction

Ewing saarcoma (malignant round-cell tumor)

76

Optochin response

Sensitive: Strep pneumoniae
Resistant: Viridans strep

77

Periosteum raised form bone, creating triangular area

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

78

Podocyte fusion or "effacement" on electron microscopy

Minimal change disease (child with nephrotic syndrome)

79

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

Eburnation (osteoarthritis resulting in bony sclerosis)

80

Protein aggregates in neurons from hyperphosphorylation of tau protein

Neurofibrillary tangles ( Alzheimer disease) and Pick bodies ( Pick disease)

81

psammoma bodies

Meningiomas, papillary thyroid carcinoma, mesothelimoa, papillary serous carcinoma of the endometrium and ovary

82

Pseudopalisading tumor cells on brain biopsy

Glioblastoma multiforme

83

RBC casts in urine

Acute glomerulonephritis

84

Rectangular, crystal-like, cytoplasmic inclusions in leydig cells

Reinke crystals ( Leydig cell tumor)

85

Renal epithelial casts in urine

Acute toxic/viral renal injury

86

Rhomboid crystals, positively birefringent

Pseudogout ( calcium pyrophosphate dihydrate crystals_

87

Rib Notching

Coarctation of the aorta

88

Ring-enhancing brain lesion in AIDS

Toxoplasma gondii, CNA lymphoma

89

Sheets of medium sized lymphoid cells with scattered pale, tingible body-laden macrophages "starry sky" histology

Burkitt lymphoma (t 8:14) c-myc activation, assoiated with EBV; "black sky" made up of maligant cells"/)

90

Silver-staining spherical aggregation of tau proteins in neurons

Pick bodies ( Pick disease: Progressive dementia; changes in personality)

91

"soap bubble" in femur or tibia on x-ray

Giant cell tumor of bone (generally benign)

92

"Spikes" on basemnt membrane, "dome-like" subepithelial deposits

membranous glomerulonephritis ( may progress to nephrotic syndrome)

93

Stacks of RBC's

Rouleaux formation ( high ESR, multople myeloma)

94

Strippled vaginal epithelial cells

"Clue cells" (gardneralla baginalis)

95

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

Birbeck granules ( Langerhans cell histiocytosis or histiocytosis X: eosinophilic granuloma)

96

Thrombi made of white/red layers

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

97

"Thumb sign" on lateral x-ray

Epiglottitis ( haemophilus influenzae)

98

Thyroid-like appearance of kidney

chronic bacterial pyelonephritis

99

"tram-track" appearance of capillary loops of glomerular basement membranes on light microscopy

Membranoproliferatice glomerulonephritis

100

Triglyceride accumulation in lever cell vacuoles

Fatty liver disease ( alcoholic or metabolic syndrome)

101

"Waxy" casts with very low urine flow

chronic end-stage renal disease

102

WBC casts in urnine

Acute pyelonephritis

103

WBC's that looked "smudge"

CLL ( almost always B cell)

104

"wire loop" glomerular capillary appearance on light microscopy

lupus nephropathy

105

Yellowish CSF

Xanthochromia ( eg, due to subarachnoid hemorrhage)