Classic Labs/Findings Flashcards
1
Q
Colonies of mucoid Psudomonas in lungs
A
Cystic fibrosis (autosomal recessive mutation in CFTR gene-> fat soluble vitamin deficiency and mucous plugs)
2
Q
V AFP in amniotic fluid/maternal serum
A
Down syndrome, Edwards syndrome
3
Q
^ ß-hCG, v PAPP-A on first trimester screening
A
Down Syndrome
4
Q
^ serum homocysteine, ^ mehtylmalonic acid, v folate
A
Vitamin B12 deficiency
5
Q
Anti-histone antibodies
A
Drug-induced SLE (eg hydralazine, isoniazid, phenytoin, TNF alpha inhibitors)
6
Q
V T cells, V PTH, V CA +2, absent thymic shadow on CXR
A
Thymic aplasia (Di George syndrome, velocardiofacial syndrome)
7
Q
Large granules in phagocytes, immunodeficiency
A
Chédiak-Higashi disease (congenital failure of phagolysosome formation)
8
Q
Recurrent infections, eczema, thrombocytopenia
A
Wiskott-Aldrich syndrome
9
Q
Optochin sensitivity
A
Sensitive: S pneumoniae; resistant viridans streptococci (S mutans, S sanguis)
10
Q
Novobiocin response
A
Sensitive S epidermidis; resistant S saprophyticus
11
Q
Bacitracin response
A
Sensitive: S pyogenes (group A); resistant: S agalactiae (group B)
12
Q
Branching gram + rods with sulfur granules
A
Actinomyces israelii
13
Q
Hilar lymphadenopathy, peripheral granulomatous lesion in middleof lower lung lobes ( can calcify)
A
Ghon complex (1º TB: Mycobacterium bacilli)
14
Q
“Thumb sign” on lateral neck x-ray
A
Epiglottitis (Haemophilus influenzae)
15
Q
Bacteria covered vaginal epithelial cells
A
Clue cells (Gardnerella Vaginalis)
16
Q
Dilated cardiomyopathy with apical atrophy
A
Chagas disease (Trypanosoma cruzi)
17
Q
Atypical lymphocytes, heterophile antibodies
A
Infectious mononucleosis (EBV infection)
18
Q
Eosinophilic intranuclear inclusions with perinuclear halo
A
Cells infected by herpesviruses (eg HSV, VZV, CMV)
19
Q
“Steeple” sign on frontal CXR
A
Croup (parainfluenza virus)
20
Q
Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar neurons
A
Negri bodies of rabies
21
Q
Ring-enhancing brain lesion on CT/MRI in AIDS
A
Toxoplasma gondii, CNS lymphoma
22
Q
Psammoma bodies
A
Meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of the endometrium and ovary
23
Q
“Delta wave” on ECG, short PR interval, supraventricular tachycardia
A
Wolff-Parkinson White syndrome (bundle of Kent bypasses AV node)
24
Q
“Boot shaped” heart on x-ray
A
Tetralogy of Fallot (due to RVH)
25
Rib notching (inferior surface on X-ray)
Coarctation of the aorta
26
Granuloma with giant cells after pharyngeal infection
Aschoff bodies (rheumatic fever)
27
Electrical alternans (alternating amplitude on ECG)
Cardiac tamponade
28
Enlarged thyroid cells with ground glass nuclei with central clearing
“Orphan Annie” eyes nuclei (papillary carcinoma of the thyroid)
29
“Brown” tumor of bone
Hyperparathyroidism or osteitis fibrosa cystica (deposited hemosiderm from hemorrhage gives brown color)
30
Hypertension, hypokalemia, metabolic alkalosis
1º hyperaldosteronism (eg Conn syndrome)
31
Mucin-filled cell with peripheral nucleus
“Signet ring” (gastric carcinoma)
32
Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies
Celiac disease (diarhea, weight loss)
33
Narrowing of bowel lumen on barium x-ray
“String sign” (Crohn disease)
34
“Lead pipe” appearance of colon on abdominal imaging
Ulcerative colitis (loss of haustra)
35
Thousands of polyps on colonoscopy
Familial adenomatous polyposis (autosomal dominant, mutation of APC gene)
36
“Apple core” lesion on barium enema x-ray
Colorectal cancer (usually left sided)
37
Eosinophilic cytoplasmic inclusion in liver cell
Mallory body (alcoholic liver disease)
38
Triglyceride accumulation in liver cell vacuoles
Fatty liver disease (alcoholic or metabolic syndrome)
39
Anti-smooth muscle antibodies (ASMAs), anti-liver/kidney microsomal-1 (anti LKM1) antibodies
Autoimmune hepatitis
40
“Nutmeg” appearance of liver
Chronic passive congestion of liver due to right heart failure or Budd-Chiari Syndrome
41
Antimitochondrial antibodies (AMAs)
1º biliary cholangitis (female, cholestasis, portal hypertension)
42
Low serum ceruloplasmin
Wilson disease (hepatolenticular degeneration; Kayser-Fleischer rings due to copper accumulation)
43
Migratory thrombophlebitis (leading to migrating DVTs and vasculitis)
Trousseau syndrome (adenocarcinoma of pancreas or lung)
44
Hypersegmented neutrophils
Megaloblastic anemia (B12 deficiency: neurologic symptoms; folate deficiency: no neurologic symptoms)
45
Basophilic nuclear remnants in RBCs
Howell-Jolly bodies (due to splenectomy or nonfunctional spleen)
46
Basophilic stippling of RBCs
Lead poisoning or sideroblastic anemia
47
Hypochromic, microcytic anemia
Iron deficiency anemia, lead poisoning, thalassemia (fetal hemoglobin sometimes present)
48
“Hair on end” (“crew cut”) appearance on x-ray
ß-thalassemia, sickle cell disease (marrow expansion)
49
Anti-GpIIb/IIIa antibodies
Immune thrombocytopenia
50
High level of D-Dimers
DVT, DIC
51
Giant B cells with bilobed nuclei with prominent inclusions ("owl's eye")
Reed-Sternberg cells (Hodgkin lymphoma)
52
Sheets of medium -sized lymphoid cells with scattered pale, tingible body- laden macrophages ("starry sky" histology)
Burkitt lymphoma (t[8:14] c myc activation, associated with EVB; "starry sky" made up of malignant cells)
53
Lytic ("punched out" ) bone lesions on x-ray
Multiple myeloma
54
Monoclonal spike on serum protein electrophoresis
Multiple myeloma (usually IgG or IgA)
Waldenström macroglobulinemia (IgM)
Monoclonal gammopathy of undetermined significance
55
Stack of RBCs
Rouleaux formation (high ESR, multiple myeloma)
56
Azurophilic peroxidase + granular inclusions in granulocytes and myeloblasts
Auer rods (APL)
57
WBCs that look "smudged"
CLL
58
"Tennis racket" -shaped cytoplasmic organelles (EM) in Langerhans cells
Birbeck granules (Langerhans cell histocytosis)
59
"Soap bubble" in femur or tibia on x-ray
Giant cell tumor of bone (generally benign)
60
Raised periosteum (creating a "Codman triangle")
Aggressive bone lesion (eg osteosarcoma, Ewing sarcoma)
61
"Onion skin" periostal reaction
Ewing sarcoma(malignant small blue cell tumor)
62
Anti-IgG antibodies
Rheumatoid arthritis (systemic inflammation, joint pannus, boutonniere and swan neck deformities)
63
Rhomboid crystals, + birefringent
Pseudogout (calcium pyrophosphate dihydrate crystals)
64
Needle shaped, - birefringent crystals
Gout (monosodium urate crystals)
65
^ uric acid levels
Gout, Lesch-Nyhan Syndrome, tumor lysis syndrome, loops and thiazide diuretics
66
"Bamboo spine" on x-ray
Ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27)
67
Antinuclear antibodies (ANAs: anti-smith and anti dsDNA)
SLE (type III hypersensitivity)
68
Antineutrophil cytoplasmic antibodies (ANCAs)
Microscopic polyangiitis and eosinophilic granulomatosis with polyangiitis (MPO-ANCA/p-ANCA); granulomatosis with polyangiitis (PR3-ANCA/c-ANCA); primary sclerosing cholangitis (MPO-ANCA/p-ANCA)
69
Anticentromere antibodies
Scleroderma (CREST syndrome)
70
Anti-topoisomerase antibodies
Diffuse scleroderma
71
Anti-desmoglein (anti-desmosome) antibodies
Pemphigus vulgaris (blistering)
72
Keratin pearls on a skin biopsy
Squamous cell carcinoma
73
^ AFP in amniotic fluid/maternal serum
Dating error, anencephaly, spina bifida (open neural tube defects)
74
Bloody or yellow tap on lumbar puncture
Xanthochromia (due to subarachnoid hemorrhage)
75
Eosinophilic cytoplasmic inclusion in neuron
Lewy body (parkinson disease and Lewy body dementia)
76
Extracellular amyloid deposition in gray matter of brain
Senile plaques (Alzheimer disease)
77
Depigmentation of neurons in substantia nigra
Parkinson disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia)
78
Protein aggregates in neurons from hyperphosphorylation of tau protein
Neurofibrillary tangles (Alzheimer disease) and Pick bodies (pick disease)
79
Silver-staining spherical aggregation of tau proteins in neurons
Pick bodies (frontotemporal dementia: progressive dementia, changes in personality)
80
Pseudopalisading pleomorphic tumor cells on brain biopsy
Glioblastoma multiforme
81
Circular grouping of dark tumor cells surrounding pale neurofibrils
Home-Wright rossettes (neuroblastoma, medulloblastoma)
82
"Waxy" casts with very low urine flow
Chronic end-stage renal disease
83
WBC casts in urine
Acute pyelonephritis, transplant rejection, tubulointerstitial inflammation
84
RBC casts in urine
Glomerulonephritis
85
Tram-track appearance of capillary loops of glomerular basement membranes on light microscopy
Membranoproliferative glomerulonephritis
86
Anti glomerular basement membrane antibodies
Goodpasture syndrome (glomerulonephritis and hemoptysis)
87
Cellular crescents in Bowman capsule
Rapidly progressive (crescentic) glomerulonephritis
88
Wire loop glomerular capillary appearance on light microscopy
Diffuse proliferative glomerulonephritis (usually seen with lupus)
89
Linear appearance of Ig G deposition on glomerular
Goodpasture syndrome
90
"Lumpy bumpy" appearance of glomeruli on immunofluorescence
Poststreptococcal glomerulonephritis (due to deposition of IgG, IgM, and C3)
91
Necrotizing vasculitis (Lungs) and necrotizing glomerulonephritis
Granulomatosis with polyangiitis (PR3-ANCA/c-ANCA) and Goodpasture syndrome (anti-basement membrane antibodies)
92
Nodular hyaline deposits in glomeruli
Kimmelstiel-Wilson nodules (diabethic nephropathy)
93
Podocyte fusion or "effacement" on electron microscopy
Minimal change disease (child with nephrotic syndrome)
94
"Spikes" on basement membrane, "dome-like" subepithelial deposits
Membranous nephropathy (nephrotic syndrome)
95
Thyroid-like appearance of kidney
Chronic pyelonephritis (usually due to recurrent infections)
96
Granular casts in urine
Acute tubular necrosis (eg ischemia or toxic injury)
97
hCG elevated
Multiple gestations, hydatidiform moles, choriocarcinoms, Down Syndrome
98
Dysplastic squamous cervical cells with "raisinoid" nuclei and hyperchromasia
Koilocytes (HPV: predisposes to cervical cancer)
99
Sheets of uniform "fried eggs" cells, ^ hCG, ^ LDH
Dysgerminoma
100
Disarrayed granulosa cells arranged around collections of eosinophilic fluid
Call-Exner bodies (granulosa cell tumor of the ovary)
101
"Chocolate cyst" of ovary
Endometriosis (frequently involves both ovaries)
102
Mammary gland ('blue dommed") cyst
Fibrocystic change of the breast
103
Glomerulus-like structure surrounding vessel in germ cells
Schiller-Duval bodies (yolk sac tumor)
104
Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells
Reinke crystals (Leydig cell tumor)
105
Thrombi made of white/red layers
Lines of Zahn (arterial thrombus, layers of platelets/RBCs)
106
Hexagonal, double-pointed, needle-like crystals in bronchial secretions
Bronchial asthma (Charcot-Leyden crystals:eosinophilic granules)
107
Desquamated epithelium casts in sputum
Curschmann spirals (bronchial asthma; can result in whorled mucous plugs)
108
"Honeycomb lung" on x-ray or CT
Idiopathic pulmonary fibrosis
109
Iron containing nodules in alveolar septum
Ferruginous bodies (asbestosis: ^ chance of lung cancer)
110
Bronchogenic apical lung tumor on imaging
Pancoast tumor (can compress cervical sympathetic chain and cause Horner syndrome)
