Classic Labs/Findings Flashcards
(106 cards)
1
Q
Low AFP in amniotic fluid/maternal serum
A
Down syndrome or other chromosomal abnormality
2
Q
Large granules in phagocytes, immunodeficiency
A
Chediak-Higashi disease (congenital failure of phagolysosome formation)
3
Q
Recurrent infections, eczema, thrombocytopenia
A
Wiskott-Aldrich syndrome
4
Q
Branching gram + rods with sulfur granules
A
Actinomyces israelii
5
Q
Optochin sensitivity
A
Sensitive: S pneumo; resistant: viridans strep (S mutans, S sanguis)
6
Q
Novobiocin response
A
Sensitive: S epi, resistant: S agalactiae (group B)
7
Q
Strep bovis bacteremia
A
Colon cancer
8
Q
Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
A
Ghon complex (primary TB - mycobacterium bacilli)
9
Q
Bacteria-covered vaginal epithelial cells
A
“Clue cells” (Gardnerella vaginalis)
10
Q
Ring-enhancing brain lesion on CT/MRI in AIDS
A
Toxoplasma gondii, CNS lymphoma
11
Q
Cardiomegaly with atypical atrophy
A
Chagas disease (Trypanosoma cruzi)
12
Q
Heterophile antibodies
A
Infectious mononucleosis (EBV)
13
Q
Intranuclear eosinophilic droplet-like bodies
A
Cowdry type A bodies (HSV or VZV)
14
Q
Eosinophilic globule in liver
A
Councilman body (viral hepatitis, yellow fever), represents hepatocyte undergoing apoptosis
15
Q
“Steeple” sign on frontal CXR
A
Croup (parainfluenza virus)
16
Q
Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar neurons
A
Negri bodies of rabies
17
Q
Atypical lymphocytes
A
EBV
18
Q
Enlarged cells with intranuclear inclusion bodies
A
“Owl eye” appearance of CMV
19
Q
“Thumb sign” on lateral neck x-ray
A
Epiglottitis (H flu)
20
Q
“Delta wave” on EKG, short PR interval, supraventricular tachycardia
A
Wolff-Parkinson-White syndrome (Bundle of Kent bypasses AV node)
21
Q
“Boot-shaped” heart on x-ray
A
Tetralogy of Fallot (due to RVH)
22
Q
Rib notching (inferior surface, on x-ray)
A
Coarctation of the aorta
23
Q
Heart nodules (granulomatous)
A
Aschoff bodies (rheumatic fever)
24
Q
Electrical alternans (alternating amplitude on EKG)
A
Pericardial tamponade
25
Hypertension, hypokalemia, metabolic alkalosis
Primary hyperaldosteronism (Conn syndrome)
26
Enlarged thyroid cells with ground-glass nuclei with central clearing
"Orphan Annie" eyes nuclei
| in papillary carcinoma of the thyroid
27
ANCAs (antineutrophil cytoplasmic antibodies)
Microscopic polyangiitis and eosinophilic granulomatosis with polyangiitis (MPO-ANCA/p-ANCA)
granulomatosis with polyangiitis (Wegener; PR3-ANCA/c-ANCA)
primary sclerosing cholangitis (MPO-ANCA/p-ANCA)
28
Mucin-filled cell with peripheral nucleus
"Signet ring"
| in gastric carcinoma
29
Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies
Celiac disease
30
Narrowing of bowel lumen on barium x-ray
"String sign"
| Seen in Crohn's
31
"Lead pipe" appearance of colon on abdominal imaging
Loss of haustra in Ulcerative colitis
32
Thousands of polyps on colonoscopy
Familial adenomatous polyposis
| Autosomal dominant, mutation of APC gene
33
"Apple core" lesion on barium enema x-ray
Colorectal cancer (usually left-sided)
34
Eosinophilic cytoplasmic inclusion in liver cell
Mallory body
| Seen in alcoholic liver disease
35
Triglyceride accumulation in liver cell vacuoles
Fatty liver disease
| In alcoholic or metabolic syndrome
36
"Nutmeg" appearance of liver
Chronic passive congestion of liver due to right heart failure or Budd-Chiari syndrome
37
Antimitochondrial antibodies (AMAs)
Seen in primary biliary cirrhosis (typically female, cholestasis, portal hypertension)
38
Low serum ceruloplasmin
Wilson's Disease
39
Migratory thrombophlebitis (leading to migrating DVTs and vasculitis)
Trousseau Syndrome (adenocarcinoma of pancreas or lung)
40
Basophilic nuclear remnants in RBCs
Howell-Jolly bodies
| 2/2 splenectomy or nonfunctional spleen
41
Hypochromic, microcytic anemia
Iron deficiency anemia
Lead poisoning
Thalassemia
42
Basophilic stippling of RBCs
Lead poisoning or sideroblastic anemia
43
"Hair on end" ("Crew-cut") appearance on x-ray
Beta-thalassemia
| Sickle cell disease (marrow expansion)
44
Hypersegmented neutrophils
Megaloblastic anemia (b12 def, folate def)
45
Antiplatelet antibodies
Idiopathic thrombocytopenic purpura
46
High level of D-dimers
DVT, PE, DIC
47
Giant B cells with bilobed nuclei with prominent inclusions ("owl's eyes")
Reed-Sternberg cells
| Characteristic of Hodgkin lymphoma
48
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
```
49
Lytic "punched-out" bone lesions on x-ray
Multiple myeloma
50
Monoclonal antibody spike
Multiple myeloma (usually IgG or IgA)
MGUS
Waldenstrom macroglobulinemia
Primary amyloidosis
51
Stacks of RBCs
Rouleaux formation (high ESR, multiple myeloma)
52
Azurophilic peroxidase + granular inclusions in granulocytes and myeloblasts
Auer rods
| Seen in AML, epsecially the promyelocytic type
53
WBCs that look "smudged"
CLL (almost always B cell)
54
"Tennis racket"-shaped cytoplasmic organelles (EM) in Langerhans cells
Birbeck granules
| Seen in Langerhans cell histiocytosis
55
"Brown" tumor of bone
Hyperparathyroidism or osteitis fibrosis cystica (deposited hemosiderin from hemorrhage gives brown color)
56
Raised periosteum (creating a "Codman triangle")
Aggressive bone lesion (eg osteosarcoma, Ewing sarcoma, osteomyelitis)
57
"Soap bubble" in femur or tibia on x-ray
Giant cell tumor of bone (generally benign)
58
"Onion skin" periosteal reaction
Ewing sarcoma (malignant small blue cell tumor)
59
Anti-IgG antibodies
Rheumatoid arthritis (systemic inflammation, joint pannus, boutonniere, swan neck deformaties)
60
Rhomboid crystals, +birefringent
Pseudogout (calcium pyrophosphate dihydrate crystals)
61
Needle-shaped, - birefringent crystals
Gout (monosidum urate crystals)
62
Increased uric acid levels
Gout
Lesch-Nyhan syndrome
Tumor lysis syndrome
Loop and thiazide diuretics
63
"Bamboo spine" on x-ray
Ankylosing spondylitis (chronic inflammatory arthritis, assoc w/ HLA-B27)
64
Antinuclear antibodies (ANAs: anti-Smith and anti-dsDNA)
SLE (type III hypersensitivity)
65
Anti-topoisomerase antibodies
Diffuse systemic scleroderma
66
Keratin pearls on a skin biopsy
Squamous cell carcinoma
67
Antihistone antibodies
Drug-induced SLE (eg hydralazine, isoniazid, phenytoin, procainamide)
68
Bloody or yellow tap on lumbar puncture
Subarachnoid hemorrhage
69
Yellowish CSF
Xanthochromia (eg due to subarachnoid hemorrhage)
70
Eosinophilic cytoplasmic inclusion in neuron
Lewy Body (Parkinson disease and Lewy body dementia)
71
Extracellular amyloid deposition in gray matter of brain
Senile plaques (Alzheimer disease)
72
Depigmentation of neurons in substantia nigra
Parkinson disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia)
73
Protein aggregates in neurons from hyperphosphorylation of tau protein
Neurofibrillary tangles (Alzheimer disease) and Pick bodies (Pick disease)
74
Silver-staining spherical aggregation of tau proteins in neurons
Pick bodies (Pick disease: progressive dementia, changes in personality)
75
Pseudopalisading tumor cells on brain biopsy
GBM
76
Circular grouping of dark tumor cells surrounding pale neurofibrils
Homer-Wright rosettes (neuroblastoma, medulloblastoma)
77
"Waxy" casts with very low urine flow
Chronic end-stage renal disease
78
RBC casts in urine
Glomerulonephritis
79
"Tram-track" appearance of capillary loops of glomerular basement membranes on light microscopy
Membranoproliferative glomerulonephritis
80
Nodular hyaline deposits in glomeruli
Kimmelstiel-Wilson nodules (diabetic nephropathy)
81
Podocyte fusion or "effacement" on electron microscopy
Minimal change disease (child with nephrotic syndrome)
82
"Spikes" on basement membrane, "dome-like" subepithelial deposits
Membranous nephropathy (nephrotic syndrome)
83
Anti-glomerular basement membrane antibodies
Goodpasture syndrome (glomerulonephritis and hemoptysis)
84
Cellular crescents in Bowman capsule
Rapidly progressive crescentic glomerulonephritis
85
"Wire loop" glomerular capillary appearance on light microscopy
Diffuse proliferative glomerulonephritis (usually seen with lupus)
86
Linear appearance of IgG deposition on glomerular and alveolar basement membranes
Goodpasture syndrome
87
"Lumpy bumpy" appearance of glomeruli on immunofluorescence
Poststreptococcal glomerulonephritis (due to deposition of IgG, IgM, and C3)
88
Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis
Granulomatosis with polyangiitis (Wegener; PR3-ANCA/c-ANCA) and Goodpasture syndrome (anti-BM antibodies)
89
Thyroid-like appearance of kidney
Chronic pyelonephritis (usually 2/2 recurrent infections)
90
WBC casts in urine
Acute pyelonephritis
91
Renal epithelial casts in urine
Intrinsic renal failure (eg ischemia or toxic injury)
92
hCG elevated
Choriocarcinoma, hydatidiform mole (occurs with and without embryo, and multiple pregnancy)
93
Dysplastic squamous cervical cells with "raisinoid" nuclei and hyperchromasia
Koilocytes (HPV: predisposes to cervical cancer)
94
Psamomma bodies
Meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of endometrium and ovary
95
Disarrayed granulosa cells arranged around collections of eosinophilic fluid
Call-Exner bodies
| Seen in granulosa cell tumor of the ovary
96
"Chocolate cyst" of ovary
Endometriosis
| Frequently involves both ovaries
97
Mammary gland ("blue domed") cyst
Fibrocystic change of the breast
98
Glomerulus-like structure surrounding vessel in germ cells
Schiller-Duval bodies (yolk sac tumor)
99
Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells
Reinke crystals (Leydig cell tumor)
100
thrombi made of white/red layers
Lines of Zahn (arterial thrombus, layers of platelets/RBCs)
101
Hexagonal, double-pointed, needle-like crystals in bronchial secretions
Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)
102
Desquamated epithelium casts in sputum
Curschmann spirals (bronchial asthma; can result in whorled mucous plugs)
103
"Honeycomb lung" on x-ray or CT
Interstitial pulmonary fibrosis
104
Colonies of mucoid Pseudomonas in lungs
Cystic fibrosis
105
Iron-containing nodules in alveolar septum
Ferruginous bodies
| Seen in asbestosis, increasing chance of lung cancer
106
Bronchogenic apical lung tumor on imaging
Pancoast tumor
