Classic Labs/Findings Flashcards
1
Q
Anticentromere antibodies
A
Scleroderma (CREST)
2
Q
Anti-desmoglein (epithelial) antibodies
A
Pemphigus vulgaris (blistering
3
Q
Anti-glomerular basement membrane antibodies
A
Goodpasture syndrome (glomerulonephritis and hemoptysis)
4
Q
Antihistone antibodies
A
Drug-induced SLE (e.g. hydralazine, isoniazid, phenytoin, procainamide)
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) (3)
A
Microscopic polyangiitis and eosinophilic granulomatosis with polyangiitis (Churg Strauss syndrome (MPO-ANCA/p-ANCA)
Granulomatosis with polyangiitis (Wegener; PR3-ANCA/c-ANCA)
8
Q
Antinuclear antibodies (ANAs: anti-Smith and anti-dsDNA)
A
SLE (Type III Hypersensitivity)
9
Q
Antiplatelet antibodies
A
Idiopathic thrombocytopenic purpura (ITP)
10
Q
Anti-topoisomerase antibodies
A
Diffuse systemic scleroderma
11
Q
Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies
A
Celiac disease (diarrhea, weight loss)
12
Q
“Apple core” lesion on barium enema x-ray
A
Colorectal cancer (usually L sided)
13
Q
Atypical lymphocytes
A
EBV
14
Q
Azurophilic peroxidase + granular inclusions in granulocytes and myeloblasts
A
Auer rods (AML, especially promyelocytic M3 type)
15
Q
Bacitracin response (2)
A
Sensitive: S. pyogenes (GAS)
Resistant: S. agalactiae (GBS)
16
Q
“Bamboo spine” on x ray
A
Ankylosing spondyliitis (chronic inflammatory arthritis, HLA B27)
17
Q
Basophilic nuclear remnants in RBCs
A
Howell-Jolly bodies (due to splenectomy or nonfunctional spleen)
18
Q
Bloody or yellow tap on LP
A
Subarachnoid hemorrhage
19
Q
“Boot-shaped” heart on XR
A
Tetralogy of Fallot (due to RVH)
20
Q
Branching gram positive rods with sulfur granules
A
Actinomyces israelii
21
Q
Bronchogenic apical lung tumor on imaging
A
Pancoast tumor (can compress cervical sympathetic chain and cause Horner syndrome)
22
Q
“Brown” tumor of bone
A
Hyperparathyroidism or osteitis fibrosa cystica (deposited hemosiderin from hemorhage gives brown color)
23
Q
Cardiomegaly with apical atrophy
A
Chagas disease (Trypanosoma cruzi)
24
Q
Cellular crescents in Bowman capsule
A
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)
27
Colonies of mucoid Pseudomonas in lungs
Cystic fibrosis (AR mut in CFTR gene yields fat soluble vitamin deficiency and mucous plugs)
28
Decreased AFP in amniotic fluid/maternal serum
Down syndrome or other chromosomal abnormalities
29
Degeneration of dorsal column fibers (2)
Tabes dorsalis (tertiary syphilis), subacute combined degeneration (dorsal columns, lateral corticospinal, spinocerebellar tracts affected)
30
"Delta wave" on EKG, short PR interval, supraventricular tachycardia
Wolf-Parkinson-White syndrom e(Bundle of Kent bypasses AV node)
31
Depigmentation of neurons in substantia nigra
Parkinson disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia)
32
Desquamated epithelium casts in sputum
Curschmann spiral (bronchial asthma, can result in worled mucous plugs)
33
Disarrayed granulosa cells arragned around collections of eosinophilic fluid
Call-Exner bodies (granulosa cell tumor of the ovary)
34
Dysplastic squamos cervical cells with "raisinoid" nuclei and hyperchromasia
Koilocytes (HPV: predisposes to cervical cancer)
35
Electrical alternans (alternating amplitude on EKG)
Pericardial tamponade
36
Enlarged cells with intranuclear inclusion bodies
"Owl eye" appearance of CMV
37
Enlarged thyroid cells with ground glass nuclei with central clearing
"Orphan Annie" eyes nuclei (papillary carcinoma of the thyroid)
38
Eosinophilic cytoplasmic inclusion in liver cell
Mallory body (alcoholic liver disease)
39
Eosinophilic cytoplasmic inclusion in nerve cell
Lewy body (Parkinson disease)
40
Eosinophilic globule in liver
Councilman body (viral hepatitis, yellow fever), represents hepatocyte undergoing apoptosis
41
Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar neurons
Negri bodies of rabies
42
Extracellular amyloid deposition in gray matter of brain
Senile plaques (Alzheimer disease)
43
Giant B cells with bilobed nuclei with prominent inclusions ("owl's eye")
Reed-Sternberg cells (Hodgkin lymphoma)
44
Glomerulus-like structure surrounding vessel in germ cells
Schiller-Duval bodies (yolk sac tumor)
45
"Hair on end" ("crew cut") appearance on x ray (2)
Beta thallassemia, sickle cell disease (marrow expansion)
46
hCG elevated (2)
Choriocarcinoma, hydatidiform mole (occurs w/ and w/out embryo, and multiple pregnancy)
47
Heart nodules (granulomatous)
Aschoff bodies (rheumatic fever)
48
Heterophile antibodies
Infectious mononucleosis (EBV)
49
Hexagonal, double pointed, needlie like crystals in bronchial secretions
Bronchail asthma (Charcot-Leyden crystals: eosinophilic granules)
50
High level of D-Dimers (3)
DVT, PE, DIC
51
Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Ghon complex (primary TB)
52
"Honeycomb lung" on XR or CT
Interstitial pulmonary fibrosis
53
Hypercoagulability (leading to migrating DVTs and vasculitis)
Trousseau syndrome (adenocarcinoma of pancreas or lung)
54
Hypersegmented neutrophils (2)
Megaloblastic anemia (B12 def: neuro symtpoms, folate def: no neuro symptoms)
55
Hypertension, hypokalemia, metabolic alkalosis
Conn syndrome (primary hyperaldosteronism)
56
Hypochromic, microcytic anemia (3)
Iron deficiency anemia
Lead poisoning
Thalassemia (fetal hemoglobin sometimes present)
57
Increased AFP in amniotic fluid/maternal serum (3)
Dating error, anencephaly, spina bifida (NTD)
58
Increased uric acid levels (4)
Gout
Lesch-Nyhan syndrome
Tumor lysis syndrome
Loop and thiazide diuretics
59
Intranuclear eosinophilic droplet-like bodies
Cowdry type A bodies (HSV or VZV)
60
Iron-containing nodules in aveolar septum
Ferruginous bodies (asbestosis: increased chance of mesothelioma)
61
Keratin pearls on a skin biopsy
Squamos cell carcinoma
62
Large granules in phagocytes, immunodeficiency
Chediak-Higashi disease (congenital failure of phagolysosome formation)
63
"Lead pipe" appearance of colon on abdominal imaging
Ulcerative colitis (loss of haustra)
64
Linear appearance of IgG deposition on glomerular and alveolar basement membranes
Goodpasture syndrome
65
Low ceruloplasmin
Wilson disease (hepatolenticular degeneration)
66
"Lumpy bumpy" appearance of glomeruli on immunofluorescence
Poststreptococcal glomerulonephritis (due to deposition of IgG, IgM, and C3)
67
Lytic ("punched out") bone lesions on x ray
Multiple myeloma
68
Mammary gland ("Blue domed") cyst
Fibrocystic change of the breast
69
Monoclonal antibody spike (4)
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Multiple myeloma (usually IgG or IgA)
Monoclonal gammopathy of undetermined significance (MGUS consequence of aging)
Waldenstrom (M protein = IgM) macroglobulinemia
Primary amyloidosis
```
70
Mucin-filled cell with peripheral nucleus
"signet ring" (gastic carcinoma)
71
Narrowing of bowel lumen on barium x ray
"String sign" (Crohn disease)
72
Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis (2)
Granulomatosis with polyangiitis (Wegener, PR3-ANCA/c-ANCA) and Goodpasture syndrome (anti-BM antibodies)
73
Needle-shaped, negatively birefringent crystals (yellow when aligned parallel, blue when across)
Gout (monosodium urate crystals)
74
Nodular hyaline deposits in glomeruli
Kimmelstiel-Wilson nodules (diabetic nephropathy)
75
Novobiocin response (2)
Sensitive: S. epidermidis
Resistant: S. saprophyticus
76
"Nutmeg" appearance of liver (2)
Chronic passive congestion of liver due to RH failure or Budd-Chiari syndrome
77
"Onion skin" periosteal reaction
Ewing sarcoma (malignant small blue cell tumor)
78
Optochin response (2/3)
Sensitive: S. pneumoniae
Resistant: viridans streptococci (S. mutans, S. sanguis)
79
Periosteum raised from bone, creating triangular area (2)
Codman triangle on x ray, Ewing sarcoma, pyogenic osteomyelitis
80
Podocyte fusion or "effacement" on electron microscopy
Minimal change disease (child with nephrotic syndrome)
81
Polished, "ivory-like" appearance of bone at cartilage erosion
Eburnation (osteoarthritis resulting in bony sclerosis)
82
Protein agggregates in neurons from hyperphosphorylation of tau protein
Neurofibrillary tangles (Alzheimer disease) and Pick bodies (Pick disease)
83
Psamomma bodies (4)
Meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serious carcinoma of the endometrium and ovary
84
Pseudopalisading tumor cells on brain biopsy
Glioblastoma multiforme
85
RBC casts in urine
Glomerulonephritis
86
Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells
Reinke crystals (Leydig cell tumor)
87
Recurrent infections, eczema, thrombocytopenia
Wiskott-Aldrich syndrome
88
Renal epithelial casts in urine
Intrinsic renal failure (like ischemia or toxic injury)
89
Rhomboid crystals, positively birefringent (blue in parallel, yellow across)
Pseudogout (calcium pyrophosphate dihydrate crystals)
90
Rib notching
Coarctation of the aorta
91
Ring-enhancing brain lesion in AIDS (2)
Toxoplasma gondii, CNS lymphoma
92
Sheets of medium sized lymphoid cells with scattered pale, tingible body-laden macrophages ("starry sky" histology)
Burkitt lymphoma (t(8:14) c-myc activations, associated with EBV. Starry sky made up of malignant cells)
93
Silver-staining spherical aggregation of tau proteins in neurons
Pick bodies (Pick disease: progressive dementia, changes in personality)
94
"Soap bubble" in femur or tibia on x ray
Giant cell tumor of bone (generally benign)
95
"Spikes" on basement membrane, "dome-like" subepithelial deposits
Membranous nephropathy (nephrotic syndrome)
96
Stacks of RBCs
Rouleaux formation (high ESR, multiple myeloma)
97
"Steeple" sign on CXR
Croup (parainfluenza virus)
98
Stippled vaginal epithelial cells
"Clue cells" (Gardnerella vaginalis)
99
Streptococcus bovis bacteremia
Colon cancer
100
"Tennis racket" shaped cytoplasmic organelles (EM) in Langerhans cells
Birbeck granules (Langerhans cell histiocytosis)
101
Thousands of polyps on colonoscopy
FAP (AD mutation of APC gene)
102
Thrombi made of white/red layers
Lines of Zahn (arterial thrombus, layers of platelets/RBCs)
103
"Thumb sign" on lateral neck x ray
Epiglottis (H. influenzae)
104
Thyroid-like appearance of kidney
Chronic pyelonephritis (usually due to recurrent infections)
105
"Tram track" appearance of capillary loops of glomerular basement membranes on light microscopy
Membranoproliferative glomerulonephritis
106
Triglyceride accumulation in liver cell vacuoles
Fatty liver disease (alcoholic or metabolic syndrome)
107
"Waxy" casts with very low urine flow
Chronic end stage renal disease
108
WBC casts in urine
Acute pyelonephritis
109
WBCs that look "smudged"
CLL (almost always B cell)
110
"Wire loop" glomerular capillary appearance on light microscopy
Diffuse proliferative glomerulonephritis (usually seen with lupus)
111
Yellowish CSF
Xanthochromia (e.g. due to subarachnoid hemorrhage)
