Classic Labs/Findings Flashcards
1
Q
Increased AFP in amniotic fluid/maternal fluid
A
Dating error
Anencephaly
Spina bifida (neural tube defects)
2
Q
Anticentromere antibodies
A
Scleroderma (CREST)
3
Q
Anti-desmoglein (anti-desmosome) antibodies
A
Pemphigus vulgaris (blistering)
4
Q
Anti-glomerular basement membrane antibodies
A
Goodpasture syndrome
glomerulonephritis and hemoptysis
5
Q
Antihistone antibodies
A
Drug-induced SLE
hydralazine, isoniazid, phenytoin, procainamide
6
Q
Anti-IgG antibodies
A
Rheumatoid arthritis (systemic inflammation, joint pannus, boutonniere deformity)
7
Q
Antimitochondrial antibodies (AMAs)
A
1ry biliary cirrhosis
female, cholestasis, portal hypertension
8
Q
Antineutrophil cytoplasmic antibodies (ANCAs)
A
Microscopic polyangiitis and eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome) (MPO-ANCA/p-ANCA)
Granulomatosis with polyangiitis (Wegener; PR3-ANCA/c-ANCA)
9
Q
Antinuclear antibodies
ANAs; anti-Smith and anti-dsDNA
A
SLE (type III hypersensitivity)
10
Q
Antiplatelet antibodies
A
Idiopathic thrombocytopenic purpura
11
Q
Anti-topoisomerases antibodies
A
Diffuse systemic scleroderma
12
Q
Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies
A
Celiac disease
diarrhea, weight loss
13
Q
“Apple core” lesion on barium enema x-ray
A
Colorectal cancer (usually left-sided)
14
Q
Atypical lymphocytes
A
EBV
15
Q
Azurophilic peroxidase + granular inclusions in granulocytes and myeloblasts
A
Auer rods (AML, especially the promyelocytic [M3] type)
16
Q
Bacitracin response
A
Sensitive: S. pyogenes (group A)
Resistant: S. agalactiae (group B)
17
Q
“Bamboo spine” on x-ray
A
Ankylosing spondylitis
chronic inflammation arthritis: HLA-B27
18
Q
Basophilic nuclear remnants in RBCs
A
Howell-Jolly bodies
due to splenectomy or nonfunctional spleen
19
Q
Basophilic stippling of RBCs
A
Lead poisoning or sideroblastic anemia
20
Q
Bloody or yellow tap on lumbar puncture
A
Subarachnoid hemorrhage
21
Q
“Boot-shaped” heart on x-ray
A
Tetralogy of Fallot (due to RVH)
22
Q
Branching gram + rods in sulfur granules
A
Actinomyces israelii
23
Q
Bronchogenic apical lung tumor on imaging
A
Pancoast tumor
can compress cervical sympathetic chain and cause Horner syndrome
24
Q
“Brown” tumor of bone
A
Hyperparathyroidism or osteitis fibrosa cystica
deposited hemosiderin from hemorrhage gives brown color
25
Cardiomegaly with apical atrophy
Chagas disease
| Trypanosoma cruzi
26
Cellular crescents in Bowman capsule
Rapidly progressive crescentic glomerulonephritis
27
"Chocolate cyst" of ovary
Endometriosis
| frequently involves both ovaries
28
Circular grouping of dark tumor cells surrounding pale neurofibrils
Homer-Wright rosettes
| neuroblastoma, medulloblastoma
29
Colonies of mucoid Pseudomonas in lungs
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Cystic fibrosis
(autosomal recessive mutation in CFTR gene --> fat-soluble vitamin deficiency and mucous plugs)
```
30
Decrease AFP in amniotic fluid/maternal serum
Down syndrome or other chromosomal abnormalities
31
Degeneration of dorsal column fibers
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Tabes dorsalis (3ry syphilis)
Subacute combined degeneration (dorsal columns, lateral corticospinal, spinocerebellar tracts affected)
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32
"Delta wave" in EKG
Short PR interval
Supraventricular tachycardia
Wolff-Parkinson-White syndrome
| Bundle of Kent bypasses AV node
33
Depigmentation of neurons in substantia nigra
Parkinson disease
| basal ganglia disorder: rigidity, resting tremor, bradykinesia
34
Desquamated epithelium casts in sputum
Curschmann spirals
| bronchial asthma; can result in whorled mucous plugs
35
Disarrayed granulosa cells arranged around collections of eosinophilic fluid
Call-Exner bodies (granulosa cell tumor of ovary)
36
Dysplastic squamous cervical cells with "raisinoid" nuclei and hyperchromasia
Koilocytes (HPV: predisposes to cervical cancer)
37
Electrical alternans (alternating amplitude on EKG)
Pericardial tamponade
38
Enlarged cells with intranuclear inclusion bodies
"Owl eye" appearance of CMV
39
Enlarged thyroid cells with ground-glass nuclei with central clearing
"Orphan Annie" eyes nuclei (papillary carcinoma of the thyroid)
40
Eosinophilic cytoplasmic inclusion in liver cell
Mallory body (alcoholic liver disease)
41
Eosinophilic cytoplasmic inclusion in neuron
Lewy body (Parkinson disease and Lewy body dementia)
42
Eosinophilic globule in liver
Councilman body (viral hepatitis, yellow fever), represents hepatocyte undergoing apoptosis
43
Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar neurons
Negri bodies of rabies
44
Extracellular amyloid deposition in grey matter of brain
Senile plaques (Alzheimer disease)
45
Giant B cells with bilobed nuclei with prominent inclusions (owl's eye)
Reed-Sternberg cells (Hodgkin lymphoma)
46
Glomerulus-like structure surrounding vessel in germ cells
Schiller-Duval bodies (yolk sac tumor)
47
"Hair on end" ("Crew-cut") appearance on x-ray
B-thalassemia, sickle cell disease (marrow expansion)
48
hCG elevated
Choriocarcinoma, hydatidiform mole (occurs with and without embryo, and multiple pregnancy)
49
Heart nodules (granulomatous)
Aschoff bodies (rheumatic fever)
50
Heterophile antibodies
Infectious mononucleosis (EBV)
51
Hexagonal, double-pointed, needle-like crystals in bronchial secretions
Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)
52
High level of D-dimers
DVT, PE, DIC
53
Hilar lymphadenopathy
| Peripheral granulomatous lesions in middle or lower lung lobes (can calcify)
Ghon complex (1ry TB: Mycobacterium bacilli)
54
"Honeycomb lung" on x-ray or CT
Interstitial pulmonary fibrosis
55
Hypercoagulability (leading to migrating DVTs and vasculitis)
Trousseau syndrome (adenocarcinoma of pancreas or lung)
56
Hyper segmented neutrophils
Megaloblastic anemia (B12 deficiency: neurologic symptoms; folate deficiency: no neurologic symptoms)
57
Hypertension
Hypokalemia
Metabolic alkalosis
1ry hyperaldosteronism (Conn syndrome)
58
Hypochromic, microcytic anemia
Iron deficiency anemia, lead poisoning, thalassemia (fetal hemoglobin sometimes present)
59
Intranuclear eosinophilic droplet-like bodies
Cowry type A bodies (HSV or VZV)
60
Iron-containing nodules in alveolar septum
Ferruginous bodies (asbestosis: increase chance of mesothelioma)
61
Keratin pearls on a skin biopsy
Squamous cell carcinoma
62
Large granules in phagocytes
| Immunodeficiency
Chédiak-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 serum 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
- Multiple myeloma (usually IgG or IgA)
- Monoclonal gammopathy of undetermined significance (MGUS consequence of aging)
- Waldenström (M protein = IgM) macroglobulinemia
- Primary amyloidosis
70
Mucin-filled cell with peripheral nucleus
"Signet ring" (gastric carcinoma)
71
Narrowing of bowel lumen on barium x-ray
"String sign" (Crohn disease)
72
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Necrotizing vasculitis (lungs)
Necrotizing glomerulonephritis
```
Granulomatosis with polyangiitis (Wegener; PR3-ANCA/c-ANCA) and Goodpasture syndrome (anti-basement membrane antibodies)
73
Needle-shaped, - birefringent crystals
Gout (monosodium urate crystals)
74
Nodular hyaline deposits in glomeruli
Kimmelstiel-Wilson nodules (diabetic nephropathy)
75
Novobiocin response
Sensitive: S epidermidis
Resistant: S saprophyticus
76
"Nutmeg" appearance of liver
Chronic passive congestion of liver due to right heart failure or Budd-Chiari syndrome
77
"Onion skin" periosteal reaction
Ewing sarcoma (malignant small blue cell tumor)
78
Optochin response
Sensitive: S pneumoniae
Resistant: viridans streptococci (S mutans, S sanguis)
79
Podocyte fusion or "effacement" on electron microscopy
Minimal change disease (child with nephrotic syndrome)
80
Polished, "ivory-like" appearance of bone at cartilage erosion
Eburnation (osteoarthritis resulting in bony sclerosis)
81
Protein aggregates in neurons from hyperphosphorylation of tau protein
Neurofibrillary tangles (Alzheimer disease) and Pick bodies (Pick disease)
82
Psammoma bodies
Meningiomas
Papillary thyroid carcinoma
Mesothelioma
Papillary serous carcinoma of the endometrium and ovary
83
Pseudopalisading tumor cells on brain biopsy
Glioblastoma multiforme
84
Raised periosteum (creating a "Codman triangle")
Aggressive bone lesion (eg osteosarcoma, Ewing sarcoma, osteomyelitis)
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 (eg ischemia or toxic injury)
89
Rhomboid crystals, + birefringent
Pseudogout (calcium pyrophosphate dihydrate crystals)
90
Rib notching (inferior surface, on x-ray)
Coarctation of aorta
91
Ring-enhancing brain lesion on CT/MRI in AIDS
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 activation, 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 frontal 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
Familial adenomatous polyposis (autosomal dominant, 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
Epiglottitis (Haemophilus 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
Increased uric acid levels
Gout
Lesch-Nyhan syndrome
Tumor lysis syndrome
Loop and thiazide diuretics
108
"Waxy" casts with very low urine flow
Chronic end-stage renal disease
109
WBC casts in urine
Acute pyelonephritis
110
WBCs that look "smudged"
CLL (almost always B cell)
111
"Wire loop" glomerular capillary appearance on light microscopy
Diffuse proliferative glomerulonephritis (usually seen with lupus)
112
Yellowish CSF
Xanthochromia (eg due to subarachnoid hemorrhages)
