Classic Labs/Findings

Question 1

Anti-Centromere Antibodies

Answer 1

Scleroderma

Part of CREST

Question 2

Anti-Desmoglein (epithelial) Antibodies

Answer 2

Pemphigus vulgaris (blistering)

Question 3

Anti-Glomerular basement membrane antibodies

Answer 3

Goodpasture syndrome

• Glomerulo-nephritis
• Hemoptysis

Question 4

Anti-Histone Antibodies

Answer 4

Drug-induced SLE

• Hydralazine
• Isonizid
• Phenytoin
• Procainamide

Question 5

Anti-IgG antibodies

Answer 5

Rheumatoid arthritis

• systemic inflammation
• joint pannus
• boutonniere deformity

Question 6

Anti-Mitochondrial antibodies (AMA)

Answer 6

1’ Biliary Cirrhosis

• Female
• Cholestasis
• Portal hypertension

Question 7

Anti-Neutrophil Cytoplasmic Antibodies

ANCAs

Answer 7

Microscopic Polyangitis

• Eosinophilic granulomatosis
• with Polyangiitis (Churg-Strauss Syndrome)
• MPO-ANCA/ p-ANCA)

Granulomatosis with Polyangiitis

• Wegener
• PR3-ANCA/ c-ANCA

Question 8

Anti-Nuclear antibodies

ANAs: Anti-Smith and Anti-dsDNA

Answer 8

SLE

- Type III Hypersensitivity

Question 9

Anti-platelet Antibodies

Answer 9

Idiopathic thrombo-cytopenic purpura

• ITP
• Missing platelets

Question 10

Anti-topoisomerase antibodies

Answer 10

Diffuse systemic scleroderma

Question 11

Anti-transglutaminase/
Anti-gliadin/
Anti-endomysial
Antibodies

Answer 11

Celiac disease

Diarrhea
Weight loss

Question 12

Apple core lesion on barium x-ray

Answer 12

Colorectal cancer

- usually left sided

Question 13

Atypical lymphocytes

Answer 13

EBV

Question 14

Azurophilic peroxidase (+)
granular inclusions in granulocytes and myeloblasts

Answer 14

Auer rods

AML esp the pro-myelocytic M3 type

Question 15

Bacitracin response

Answer 15

Sensitive: S. pyogenes (group A)

Resistant: S. agalactiae (group B)

Question 16

Bamboo spine on x-ray

Answer 16

Ankylosing spondylitis

• chronic inflammatory arthritis: HLA-B27

Question 17

Basophilic nuclear remnants in RBCs

Answer 17

Howell-Jolly bodies

• d/t spenectomy or non-functional spleen

Question 18

Basophilic stippling of RBCs

Answer 18

Lead poisoning
-or-
Sideroblastic anemia

Question 19

Bloody or yellow tap on lumbar puncture

Answer 19

Subarachnoid hemorrhage

Question 20

Boot-shaped heart on x-ray

Answer 20

Tetralogy of Fallot (d/t RVH)

Question 21

Branching gram-positive rods with sulfur granules

Answer 21

Actinomyces israelii

Question 22

Bronchogenic apical lung tumor on imaging

Answer 22

Pancoast tumor

- can compress cervical sympathetic chain –> Horner syndrome

Question 23

“Brown” tumor of bone

Answer 23

Hyper-Parathyroidism
-or-
Osteitis fibrosa cystica (deposited hemosiderin from hemorrhage give brown color)

Question 24

Cardiomegaly with apical atrophy

Answer 24

Chagas disease (Trypanosoma cruzi)

Question 25

Cellular crescents in Bowman capsule

Answer 25

Rapidly progressive crescentic glomerulonephritis

Question 26

"Chocolate cyst" of ovary

Answer 26

Endometriosis | - frequently involves both ovaries

Question 27

Circular grouping of dark tumor cells surrounding pale neurofibrils

Answer 27

Homer-Wright rosettes - Neuroblastoma - or- - Medullobastoma

Question 28

Colonies of mucoid Pseudomonas in lungs

Answer 28

Cystic fibrosis - Auto recessive mutation of CFTR gene - results in Fat-soluble vitamin deficiency and mucus plugs

Question 29

DEC AFP in amniotic fluid/maternal serum

Answer 29

Down syndrome -or- other chromosomal abnormality

Question 30

Degeneration of dorsal column fibers

Answer 30

- Tabes dorsalis (3' syphilis) - or- - Sub acute combined degeneration (dorsal columns, lateral corticospinal, spino-cerebellar tracts affected)

Question 31

Delta wave on EKG Short PR interval Supraventricular tachycardia

Answer 31

Wolf Parkinson White - Bundle of Kent bypasses AV node

Question 32

Depigmentation of neurons in substatial nigra

Answer 32

Parkinson disease - Basal ganglia disorder - rigidity - resting tremor - brady-kinesia

Question 33

Desquamated epithelium casts in sputum

Answer 33

Curschmann spirals - Bronchial asthma - can result in whorled mucous plugs

Question 34

Disarrayed granulosa cells arranged around collections of eosinophilic fluid

Answer 34

Call-exner bodies | - granulosa cell tumor of the ovary

Question 35

Dysplastic squamous cervical cells with "raisinoid" nuclei and hyperchromasia

Answer 35

Koilocytes | HPV: Predisposes to cervical cancer

Question 36

Periodic acid schiff - Breast - Macrophages - Bone - Glycogen storage disease - Epidermial lymphocytes

Answer 36

Periodic acid schiff - Breast - Paget - Macrophages - Whipple - Bone - Ewing - Glycogen storage disease - Pompe II - Epidermal lymphocytes - Mycoses fungoides & Seazery syndrome

Question 37

Electrical alterans | alternating amplitude on EKG

Answer 37

Pericardial tamponade

Question 38

Enlarged cells with intra-nuclear inclusion bodies

Answer 38

Owl Eye