Classic Labs/Findings Flashcards
1
Q
Increased AFP in amniotic fluid/maternal serum
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 (eg, hydralazine, insoniazid, phenytoin, procainamide)
6
Q
Anti-IgG antibodies
A
Rheumatoid arthritis (systemic inflammation, joint pannus, boutonniere deformity)
7
Q
Antimitochondrial antibodies (AMAs)
A
Primary biliary cirrhosis (female, cholestasis, portal hypertension)
8
Q
Anitneutrophil Cytosplasmic Antibodies (ANCAs)
A
Microscopic polyangiitis and eosinophlic granulomatosis with polyangiitis (Churg-Strauss syndrome) (MPO-ANCA/p-ANCA); granulomatosis with polyangiitis (Wegener; PR3-ANCA/c-ANCA)
9
Q
Antiplatelet antibodies
A
SLE (type III hypersensitivity)
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 of barium enema XR
A
Colorectal cancer (usually left sided)
13
Q
Atypical lymphocytes
A
EBV
14
Q
Azurophilic peroxidase positive granular inclusion in granulocytes and myeloblasts
A
Auer rods (AML, especially the promyelocytic [M3] type)
15
Q
Bacitracin response
A
Sensitive: S pyogenes (group A); resistance: S agalactiae (group B)
16
Q
“Bamboo spine” on XR
A
Ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27)
17
Q
Basophilic nuclear remnants in RBCs
A
Howell-Jolly bodies (due to splenectomy or nonfunctional spleen)
18
Q
Basophilic stippling of RBCs
A
Lead poisoning or sideroblastic anemia
19
Q
Bloody or yellow tap on lumbar puncture
A
Subarachnoid hemorrhage
20
Q
“boot-shaped” heart on XR
A
Tetralogy of Fallot (due to RVH)
21
Q
Branching gram positive rods with sulfur granules
A
Actinomyces israelii
22
Q
Bronchogenic apical lung tumor on imaging
A
Pancoast tumor (can compress cervical sympathetic chain and cause Horner syndrome)
23
Q
Cardiomegaly with apical atrophy
A
Chagas disease (trypanosoma cruzi)
24
Q
Cellular crescents in Bowman’s capsule
A
Rapidly progressive crescentic glomerulonephritis
25
"Chocolate cysts" 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 mutation in CFTR gene --> 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
Tabes dorsalis (tertiary syphilis), subacute combined degeneration (dorsal columns, lateral corticospinal spinocerebellar tracts affected)
30
"Delta wave" on EKG, short PR interval, supraventricular tachycardia
Wolff-Parkinson-White syndrome (Bundle of Kent bypasses AV node)
31
Depigmentation of neurons in the substantia nigra
Parkinson disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia)
32
Desquamated epithelium casts in sputum
Cruschmann spirals (bronchial asthma; can result in whorled mucous plugs)
33
Disarrayed granulosa cells arranged around collections of eosinophilic fluid
Call-Exner bodies (granulosa cell tumor of the ovary)
34
Dysplastic squamous 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 neuron
Lewy body (Parkinson disease and Lewy body dementia)
40
Eosinophilic globule in liver
Councilman body 9viral 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-Sterberg 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 XR
β-thalassemia, sickle cell disease (marrow expansion)
46
hCG elevated
Choriocarcinoma, hydatidiform mole (occurs with and without embryo, and multiple pregnancy)
47
Heart nodules (granulomatous)
Aschoff bodies (rheumatic fever)
48
Heterophile antibodies
Infectious mononucleosis (EBV)
49
Hexagonal, double-pointed, needle-like crystals in bronchial secretions
Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)
50
High level of D-dimers
DVT, PE, DIC
51
Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
Ghon complex (Primary TB: mycobacterium bacilli)
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
Megalobastic anemia (B12 deficiency: neurologic symptoms; folate deficiency: no neurologic symptoms)
55
Hypertension, hypokalemia, metabolic alkalosis
Primary hyperaldosteronism (Conn syndrome)
56
Hypochromic, microcytic anemia
Iron deficiency anemia, lead poisoning, thalassemia (fetal hemoglobin sometimes present)
57
Intranuclear eosinophilic droplet-like bodies
Cowddry type . bodies (HSV or VZV)
58
Iron-containing nodule in alveolar septum
Ferruginous bodies (asbestosis: increased chance of mesothelioma)
59
Keratin pearls on a skin biopsy
Squamous cell carcinoma
60
Large granules in phagocytes, immunodeficiency
Chediak-Higashi disease (congenital failure of phagolysosome formation)
61
"lead pipe" appearance of colon on abdominal imaging
Ulcerative colitis (loss of haustra)
62
Linear appearance if IgG deposition of glomerular and alveolar basement membranes
Goodpasture syndrome
63
Low serum ceruloplasmin
Wilson disease (hepatolenticular degeneration)
64
"lumpy bumpy" appearance of glomeruli on immunofluorescence
Poststreptococcal glomerulonephritis (due to deposition of IgG, IgM, and C3
65
Lytic (punched-out) bone lesions on XR
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 aging), 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 XR
"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 IgG Abs)
71
Needle-shaped, negative birefringent crystals
Gout (monosodium urate crystals)
72
Nodular hyaline deposits in glomeruli
Kimmelstein-Wilson nodules (diabetic neuropathy)
73
Novobiocin response
Sensitive: S. epidermidis; Resistant: S. saprophyticus
74
"Nutmeg" liver
Chronic passive congestion of liver due to right heart failure or Budd-Chiari syndrome
75
"Onion skin" periosteal reaction
Ewing sarcoma (malignant small blue cell tumor)
76
Optochin response
Sensitive: S. pneumoniae; Resistant: S. viridans (mutan,/sanguis)
77
Podocyte fusion or "effacement" on electron microscopy
Minimal change disease (child with nephrotic syndrome)
78
Polished, "ivory-like" appearance of bone at cartilage erosion
Eburnation (osteoarthritis resulting in bony sclerosis)
79
Protein aggregates in neurons from hyperphosphorylation of tau protein
Neurofibrillary tangles (Alzheimer disease) and Pick bodies (Pick disease)
80
Psammoma bodies
Meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serious carcinoma of the endometrium and ovary
81
Pseudopalisading tumor cells on brain biopsy
Glioblastoma multiforme
82
Raised periosteum (creating a "Codman triangle")
Aggressive bone lesion (ex: osteosarcoma, Ewing sarcoma, osteomyelitis)
83
RBC casts in urine
Glomerulonephritis
84
Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells
Reinke crystals (Leydig cell tumor)
85
Recurrent infections, eczema, thrombocytopenia
Wiskott-Aldrich syndrome
86
Renal epithelial casts in urine
Intrinsic renal failure (ex: ischemia or toxic injury)
87
Rhomboid crystals, positive birefringence
Pseudogout (calcium pyrophospahte dihydrate crystals)
88
Rib notching (inferior surface on XR)
Coarctation of the aorta
89
Ring-enhancing brain lesion of CT/MRI and AIDS
Toxoplasma gondii, CNS lymphoma
90
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 EBG; "starry sky" made up of malignant cells)
91
Silver-staining spherical aggregation of tau proteins in neurons
Pick bodies (Pick disease: progressive dementia, changes in personality)
92
"Soap bubble" in femur or tibia on XR
Giant cell tumor of bone (generally benign)
93
"Spikes" on basement membrane, "dome-like" subepithelial deposits
Membranous nephropathy (nephrotic syndrome)
94
Stacks of RBCs
Rouleaux formation (high ESR, multiple myeloma)
95
"Steeple" sign on frontal CXR
Croup (parainfluenza virus)
96
Stippled vaginal epithelial cells
"Clue cells" (Gardnerella vaginalis)
97
Streptococcus bovis bacteremia
Colon cancer
98
"Tennis racket" shaped cytoplasmic organelles (EM) in Langerhans cells
Birbeck granules (Langerhans cell histiocytosis)
99
Thousands of polyps on colonoscopy
Familial adenomatous polyposis (autosomal dominant, mutation of APC gene)
100
Thrombi made of white/red layers
Lines of Zahn (arterial thrombus, layers of platelets/RBCs)
101
"Thumb sign" on lateral neck XR
Epiglottitis (Haemophilus influenzae)
102
Thyroid-like appearance of kidney
Chronic pyelonephritis (usually due to recurrent infections)
103
"Tram-track" appearance of capillary loops of glomerular basement membranes on light microscopy
Membranoproliferative glomerulonephritis
104
Triglyceride accumulation in liver cell vacuoles
Fatty liver disease (alcoholic or metabolic syndrome)
105
Increased uric acid levels
Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics
106
"Waxy" casts with very low urine flow
Chronic end-stage renal disease
107
WBC casts in urine
Acute pyelonephritis
108
WBCs that look "smudged"
Chronic Lymphocytic Leukemia (almost always B cell)
109
"Wire loop" glomerular capillary appearance on light microscopy
Diffuse proliferative glomerulonephritis (usually seen in SLE)
110
Yellowish CSF
Xanthochromia (ex: due to subarachnoid hemorrhages)
