Classic Labs/Findings Flashcards by Daniel Coquyt

Anticentromere antibodies

Scleroderma (CREST)

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Anti-desmoglein (epithelial) antibodies

Pemphigus vulgaris (blistering)

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Anti-glomerular basement membrane antibodies

Goodpasture syndrome (glomerulonephritis and hemoptysis)

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Antihistone antibodies

Drug induced SLE (hydralazine, INH, phenytoin, procainamide)

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Anti-IgG antibodies

Rheumatoid arthritis (systemic inflammation, joint pannus, boutonniere deformity)

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Antimitochondrial antibodies (AMAs)

Primary biliary cirrhosis (female, cholestasis, portal hypertension)

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Antineutrophil cytoplasmic antibodies (ANCAs)

Microscopic polyangiitis and Churg Strauss snydrome (MPO-ANCA/p-ANCA); granulomatosis with polyangiitis (Wegner; PR3-ANCA/c-ANCA)

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Antinuclear antibodies (ANA: anti-Smith and anti dsDNA)

SLE (Type III hypersensitivity)

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Antiplatelet antibodies

Idiopathic thrombocytopenic purpura

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Anti-topoisomerase antibodies

Diffuse systemic scleroderma

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Anti-transglutaminase/anti gliadin/anti-endomysial antibodies

Celiac disease (diarrhea, distention, weight loss)

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“Apple core” lesion on abdominal x-ray

Colorectal cancer (usually left sided)

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Azurophilic peroxidase-positive granular inclusions in granulocytes and myeloblasts

Auer rods (AML, especially promyelocytic M3 type, treat with all trans retinoic acid)

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Bacitracin response

Sensitive: Streptococcus pyogenes (group A); resistant: Streptococcus agalactiae (group B)

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“Bamboo spine” on xray

Ankylosing spondylitis (chronic inflammatory arthritis: HLA B27)

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Basophilic nuclear remnants in RBCs

Howell Jolly bodies (due to splenectomy or nonfunctional spleen)

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Basophilic stippling of RBCs

Lead poisoning or sideroblastic anemia

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Bloody tap on LP

Subarachnoid hemorrhage

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“Boot shaped” heart on X-ray

Tetralogy of Fallot, RVH

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Branching gram-positive rods with sulfur granules

Actinomyces israelii

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Bronchogenic apical lung tumor on imaging

Pancoast tumor (can suppress sympathetic ganglion and cause Horner syndrome)

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“Brown” tumor of bone

HyperPTH or osteitis fibrosa cystica (deposited hemosiderin from hemorrhage gives brown color)

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Cardiomegaly with apical atrophy

Chagas disease (Trypanosoma cruzi)

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Cellular crescents in Bowman capsule

Rapidly progressive crescentic glomerulonephritis

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"Chocolate cyst" of ovary

Endometriosis (frequently involves both ovaries)

Circular grouping of dark tumor cells surrounding pale neurofibrils

Homer-Wright rosettes (neuroblastoma, medulloblastoma, retinoblastoma)

Colonies of mucoid Pseudomonas in lungs

Cystic fibrosis (autosomal recessive mutation in CFTR gene-->fat soluble vitamin deficiency and mucous plugs)

Decreased AFP in amniotic fluid/maternal serum

Down syndrome or other chromosomal abnormality

Degeneration of dorsal column nerves

Tabes dorsalis (tertiary syphilis), subacute combined degeneration (dorsal columns and lateral corticospinal tracts affected)

Depigmentation of neurons in substantia nigra

Parkinson disease (basal ganglia disorder: rigidity, resting, tremor, bradykinesia)

Desquamated epithelium casts in sputum

Curschmann spirals (bronchial asthma; can result in whorled mucous plugs)

Disarraged granulosa cells in eosinophilic fluid

Call-Exner bodies (granulosa-theca cell tumor of the ovary)

Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia

Koilocytes (HPV: predisposes to cervical cancer)

Enlarged cells with intranuclear inclusion bodies

"owl-eye" appearance of CMV

Enlarged thyroid cells with ground-glass nuclei

"Orphan-Annie" eyes nuclei (papillary carcinoma of the thyroid)

Eosinophilic cytoplasmic inclusion in liver cell

Mallory body (alcoholic liver disease)

Eosinophilic cytoplasmic inclusion in nerve cell

Lewy body (Parkinson disease)

Eosinophilic globule in liver

Councilman body (toxic or viral hepatitis, often yellow fever)

Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar nerve cells

Negri bodies of rabies

Extracellular amyloid deposition in gray matter of brain

Senile plaques (Alzheimer disease)

Giant B cells with bilobed nuclei with prominent inclusions ("owl's eyes)

Reed-Sternberg cells (Hodgkin lymphoma)

Glomerulus-like structure surrounding vessel in germ cells

Schiller-Duval bodies (yolk-sac tumor)

"Hair-on-end" (crew cut) appearance on x-ray

B-thalassemia, sickle cell anemia (marrow expansion due to increased hematopoesis)

hCG elevated

Choriocarcinoma, hydatidiform mole (occrs with and w/out embryo, and multiple pregnancy)

Heart nodules (granulomatous)

Aschoff bodies (rheumatic fever)

Heterophile antibodies

Infectious mononucleosis (EBV)

Hexagonal, double-pointed, needle-like crystals in bronchial secretions

Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)

High level of D-Dimers

DVT, PE, DIC

Hilar LAD, peripheral granulomatous lesion in middle or lower lung lobes (can calcify)

Ghon complex (primary TB: Mycobacterium bacilli)

"Honey comb lumg" on xray or CT

Interstitial pulmonary fibrosis

Hypercoagulability (leading to migrating DVTs and vasculitis)

Trousseau syndrome (adenocarcinoma of pancreas or lung)

Hypersegmented neutrophils

Megaloblastic anemia (B12 deficiency: neurologic symptoms; folate deficiency: no neurologic symptoms)

Hypertension, hypokalemia, metabolic alkalosis

Conn syndrome (hyper-aldosteronism)

Increased uric acid levels

Gout, lesch-nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics

Intranuclear eosinophilic droplet-like bodies

Cowdry type A bodies (HSV or CMV)

Iron-containing nodules in alveolar septum

Ferruginous bodies (asbestosis: increased chance of mesothelioma)

Keratin pearls on a skin biopsy

Squamous cell carcinoma

Large lysosomal vesicles in phagocytes, immunodeficiency

Chediak-Higashi disease (congenital failure of phagolysosome formation)

"Lead pipe" appearance of colon on barium enema x-ray

Ulcerative colitis (loss of haustra)

Linear appearance of IgG deposition on glomerular basement membrane

Goodpasture syndrome

Low serum ceruloplasmin

Wilson disease (hepatolenticular degeneration)

"Lumpy bumpy" appearance of glomeruli on immunofluorescence

Post-streptococcal glomerulonephritis (immune complex deposition of IgG and C3b)

Lytic (hole punched) bone lesions on x-ray

Multiple myeloma

Mammary gland ("blue domed") cyst

Fibrocystic change of the breast

Monoclonal antibody spike

Multiple myeloma (IgG or IgA); MGUS (aging); Waldenstrom (M protein = IgM); Primary amyloidosis

Mucin-filled cell with peripheral nucleus

"signet ring" (gastric carcinoma)

Narrowing of bowel lumen on barium x-ray

"String sign" (Crohn disease)

Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis

Granulomatosis w/ polyangiitis (Wegener; PR3-ANCA/c-ANCA) and Goodpasture syndrome (anti-basement membrane antibodies)

Needle-shaped, negatively birefringent crystals

Gout (monosodium urate crystals)

Nodular hyaline deposits in glomeruli

Kimmelstiel-Wilson nodule (diabetic neuropathy)

Novobiocin response

Sensitive: Staphylococcus epidermidis; resistant: Staphylococcus saprophyticus

"Nutmeg" appearance of liver

Chronic passive congestion of liver due to right heart failure

"Onion skin" periosteal reaction

Ewing sarcoma (malignant round-cell tumor)

Optochin response

Sensitive: streptococcus pneumoniae; resistant: viridans streptococci

Periosteum raised from bone, creating triangular area

Codman triangle on x-ray (osteosarcoma, Ewing sarcoma, pyogenic osteomyelitis)

Podocyte fusion or "effacement" on electron microscope

Minimal change disease (child with nephrotic syndrome)

Polished, "ivory-like" appearance of bone at cartilage erosion

Eburnation (osteoarthritis resulting in bony sclerosis)

Protein aggregates in neurons from hyperphosphorylation of tau protein

Neurofibrillary tangles (Alzheimer disease) and Pick bodies (Pick disease)

Psammoma bodies

Papillary thyroid carcinoma, serous carcinoma of the endometrium and ovary, mesothelioma, meningiomas

Pseudopalisading tumor cells on brain biopsy

Glioblastoma multiforme

RBC casts in urine

Acute glomerulonephritis

Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells

Reinke crystals (Leydig cell tumor)

Renal epithelial casts in urine

Acute toxic/viral renal injury

Rhomboid crystals, positively birefringement

Pseudogout (CPPD crystals)

Rib notching

coarctation of the aorta

Ring-enhancing brain lesions in AIDS

Toxoplasma gondii, CNS lymphoma

Sheets of medium-sized lymphoid cells with scattered pale, tingible body-laden macrophages ("starry sky" histology)

Burkitt lymphoma ([t8:14] c-myc activation, associated with EBV; "black-sky" made up of malignant cells)

Silver-staining spherical aggregation of tau proteins in neurons

Pick bodies (Pick disease: progressive dementia, changes in personality)

"Soap bubble" in femur or tibia on X-ray

Giant cell-tumor of bone (generally benign)

"Spikes" on basement membrane, "dome-like" subepithelial deposits

Membranous glomerulonephritis (may progress to nephrotic syndrome)

Stacks of RBCs

Rouleaux formation (high ESR, multiple myeloma)

Stippled vaginal epithelial cells

"Clue cells" (Gardnerella vaginalis)

"Tennis racket"-shaped cytoplasmic organelles (EM) in Langerhans cells

Birbeck granules (Langerhans cell histiocytosis or histiocytosis X: eosinophilic granuloma)

Thrombi made of white/red layers

Lines of Zahn (arterial thrombus, layers of platelets/RBCs), pre-mortem clot

"Thumb sign" on lateral x-ray

Epiglottitis (Haemophilus influenza)

Thyroid-like appearance of kidney

Chronic bacterial pyelonephritis

"Tram-track" appearance of capillary loops of glomerular basement membranes on light microscopy

Membranoproliferative glomerulonephritis

Triglyceride accumulation in liver cell vacuoles

Fatty liver disease (alcoholic or metabolic syndrome)

"Waxy" casts with very low urine flow

Chronic end-stage renal disease

WBC casts in urine

Acute pyelonephritis

WBCs that look smudged

CLL (almost always B-cell)

"Wire loop" glomerular capillary appearance on light microscopy

Lupus nephropathy

Yellowish CSF

Xanthochromia (eg due to subarachnoid hemorrhage)