Classic labs/findings Flashcards
(106 cards)
1
Q
Decreased AFP in amniotic fluid/maternal serum
A
Down syndrome or other chromosomal abnormalities
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. pneumoniae; resistant: viridans streptococci (S. mutans, S, sanguis)
6
Q
Novobiocin response
A
Sensitive: S epidermidis; resistant: S saprophyticus
7
Q
Bacitracin response
A
Sensitive: S pyogenes (group A); resistant : S agalactiae (group B)
8
Q
Streptococcus bovis bactermia
A
Colon cancer
9
Q
Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calficy)
A
Ghon complex (primary TB: Mycobacterium bacilli)
10
Q
Bacteria- covered vaginal epithelial cells
A
Clue cells (Gardnerella vaginalis)
11
Q
Ring-enhancing brain lesion on CT/MRI in AIDS
A
Toxoplasma gondii, CNS lymphoma
12
Q
Cardiomegaly with apical atrophy
A
Chagas disease (Trypanosoma cruzi)
13
Q
Heterophile antibodies
A
Infectious mononucleosis (EBV)
14
Q
Intranuclear eosinophilic droplet-like bodies
A
Cowdry type A bodies (HSV or VZV)
15
Q
Eosinophilic globule in liver
A
Councilman body (viral hepatitis, yellow fever), represents hepatocyte undergoing apoptosis)
16
Q
Steeple sign on frontal CXR
A
Croup (parainfluenza virus)
17
Q
Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar neurons
A
Negri bodies of rabies
18
Q
Atypical lymphocytes
A
EBV
19
Q
Enlarged cells with intranuclear inclusion bodies
A
Owl eye appearance of CMV
20
Q
Thumb sign on lateral neck xray
A
Epiglottitis (hemophilus influenza)
21
Q
Delta wave on ECG, short PR interval, supraventricular tachycardia
A
Wolff Parkinson White syndrome (Bundle of Kent bypasses AV node)
22
Q
Boot shaped heart on xray
A
Tetralogy of Fallot (due to RVH)
23
Q
Rib notching (inferior surface, on x-ray)
A
Coarctation of aorta
24
Q
Heart nodules (granulomatous)
A
Aschoff bodies (rheumatic fever)
25
Electrical alternans (alternating amplitude on ECG)
Pericardial tamponade
26
hypertension, hypokalemia, metabolic alkalosis
Primary hyperaldosteronism (Conn syndrome)
27
Enlarged thyroid cells with ground glass nuclei with central clearing
Orphan Annie eyes nuceli (papillary carcinoma of the thyroid)
28
ANCAs
Microscopic polyangitis and eosinophilic granulomatous with polyangitis (MPO-ANCA/p-ANCA); granulomatous with polyangitis (Wegner; PR3- ANCA/c-ANCA); primary sclerosing cholangitis (MPO-ANCA/ p-ANCA)
29
Mucin-filled cell with peripheral nucleus
Signet ring (gastric carcinoma)
30
Anti-transglutaminase/ anti-gliadin/ anti-endomysial antibodies
Celiac disease (diarrhea, weight loss)
31
Narrowing of bowel lumen on barium x-ray
string sign (Crohn disease)
32
Lead pipe appearance of colon on abdominal imaging
Ulcerative colitis (loss of haustra)
33
Thousands of polyps of colonoscopy
FAP ( autosomal dominant, mutation of APC gene)
34
apple core lesion on barium enema x-ray
colorectal cancer (usually left-sided)
35
eosinophilic cytoplasmic inclusion in liver cell
Mallory body (alcoholic liver disease)
36
triglyceride accumulation in liver cell vacuoles
Fatty liver disease (alcoholic of metabolic syndrome)
37
Nutmeg appearance of liver
chronic passive congestion of liver due to right heart failure or Budd Chiari syndrome
38
Antimitochondrial antibodies
PBC (female, cholestasis, portal hypertension)
39
Low serum ceruloplasmin
Wilson disease (hepatolenticular degeneration; Kayser- Fleishcer rings due to copper accumulation)
40
Migratory thrombophlebitis (leading to migrating DVTs and vasculitis)
Trousseau syndrome (adenocarcinoma of pancreas or lung)
41
Basophilic nuclear remnants in RBCs
Howell-Jolly bodies (due to splenectomy or nonfunctional spleen)
42
Hypochromic, microcytic anemia
IDA, lead poisoning, thalessemia (fetal hemoglobin sometimes present)
43
Basophilic stippling of RBCs
Lead poisoning of sideroblastic anemia
44
Hair on end (Crew cut) appearance on x-ray
B-thalessemia, sickle cell disease (marrow expansion)
45
Hypersegmented neutrophils
Megaloblastic anemia (B12 deficiency: neurologic symptoms; folate deficiency: no neurologic symptoms
46
Antiplatelet antibodies
Idiopathic thrmobocytopenic purpura
47
High level of D-dimers
DVT, PE, DIC
48
Giant B cells with bilobed nuclei with prominent inclusion (owls eye)
Reed-Sternberg (Hodgkin Lymphoma)
| {Enlarged cells with intranuclear inclusion bodies = owl eye appearance of CMV}
49
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)
50
Lytic (punched out) bone lesions on x-ray
multiple myeloma
51
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
52
Stacks of RBCs
Rouleaux formation (high ESR, multiple myeloma)
53
Axurophilic peroxidase + granular inclusions in granulocytes and myelobasts
Auer rods (AML, especially the promyelocytic (M3) type)
54
WBCs that look smudged
CLL (almost always B cell)
55
Tennis racket- shaped cytoplasmic organelles (EM) in Langerhans cells
Birbeck granules (Langerhans cell histiocytosis)
56
Brown tumor of bone
Hyperparathyroidism or osteitis fibrosa cystica (deposited hemosiderin from hemorrhage gives brown color)
57
Raised periosteum (creating a Codman triangle)
Aggressive bone lesion (eg, osteosarcoma, Ewing sarcoma, osteomyelitis)
58
Soap bubble in femur or tibia on x-ray
Giant cell tumor of bone (generally benign)
59
Onion skin periosteal reaction
Ewing sarcoma (malignant small blue cell tumor)
60
Anti-IgG antibodies
RA (Systemic inflammation, joint pannus, boutonniere and swan neck deformities)
61
Rhomboid cystals, + birefringent
Pseudogout (calcium pyrophosphate dihydrate crystals)
62
Needle-shaped, - birefringent crystals
Gout (monosodium urate crystals)
63
Increased uric acid levels
Gout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop and thiazide diuretics
64
Bamboo spine on x-ray
Ankylosing spondylitis (chronic inflammatory arthritis HLA-B27)
65
Antinuclear antibodies (ANAs: anti-Smith and anti-dsDNA)
SLE (type III hypersensitivity)
66
Anti-topoisomerase antibodies
Diffuse systemic scleroderma
67
Kerain pearls on a skin biopsy
Squamous cell carcinoma
68
Antihistone antibodies
Drug induced SLE (eg; hydralazine, isoniazid, phenytoin, procainamide)
69
Bloody or yellow tap on lumbar puncture
SAH
70
Yellowish CSF
Xanthochromia (eg; due to SAH)
71
Eosinophilic cytoplasmic inclusion in neuron
Lewy body (Parkinson disease and Lewy body dementia)
72
Extracellular amyoid deposition in gray matter of brain
Senile plaques (Alzheimer disease)
73
Depigmentation of neurons in substantia nigra
Parkinson disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia)
74
Protein aggregates in neurons from hyperphosphorylation of tau protein
Neurofibrillary tanges (Alzheimer disease) and Pick bodies (Pick disease)
75
Silver-staining spherical aggregation of tau proteins in neurons
Pick bodies (Pick disease: progressive dementia, changes in personality)
76
Pseudopalisading tumor cells on brain biopsy
Glioblastoma multiforme
77
Circular grouping of dark tumor cells surrounding pale neurofibrils
Homer-Wright rosettes (neuroblastoma, medulloblastoma)
78
Waxy casts with very low urine flow
Chronic end stage renal diseas
79
RBC casts in urine
Glomerulonephritis
80
Tram-track appearance of capillary loops of glomerular basement membranes on light microscopy
membranoproliferative glomerulonephritis
81
Nodular hyaline deposits in glomeruli
Kimmesteil- Wilson nodules (diabetic nephropathy)
82
Podocyte fusion or effacement on electron microscopy
Minimal change disease (child with nephrotic syndrome)
83
Spikes on basement membrane, dome-like subepithelial deposits
membranous nephropathy (nephrotic syndrome)
84
anti-glomerular basement membrane antibodies
goodpasture syndrome (glomerulonephritis and hemoptysis)
85
Cellular crescents in Bowman capsule
Rapidly progressive crescentic glomerulonephritis
86
Wire loop glomerular capillary appearance on light microscopy
diffuse proliferative glomerulonephritis (usually seen with lupus)
87
Linear appearance of IgG deposition on glomerular and alveolar basement membranes
Goodpasture syndrome
88
Lumpy bumpy appearance of glomeruli on immunofluorescence
Poststreptococcal glomerulonephritis (due to deposition of IgG, IgM, C3)
89
Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis
granulomatosis with polyangitis (Wegner; PR3- ANCA/ c-ANCA) and Goodpasture syndrome (anti-basement membrane antibodies)
90
Thyroid like appearance like kidney
Chronic pyelonephritis (usually due to recurrent infections)
91
WBC casts in urine
Acute pyelonephritis
92
hCG elevated
Choriocarcinoma, hydatidiform mole (occurs with and without embryo, and multiple pregnancy)
93
Dysplastic squamous cervical cells with rasinoid nuclei and hyperchromasia
Koilocytes (HPV: predisposes to cervical cancer)
94
Psammoma bodies
Meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of the endometrium and ovary
95
Disarrayed granulosa cells arranged around collections of eosinophilic fluid
Call exner bodies (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 crustals 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 xray or CT
Interstitial pulmonary fibrosis
104
Colonies of mucoud Pseudomonas in lungs
Cystic fibrosis (autosomal recessive mutation in CFTR gene= fat-soluble vitamin deficiency and mucous plugs)
105
Iron-containing nodules in alveolar sputums
Ferruginous bodies (asbestosis: increased change of lung cancer
106
Bronchogenic apical lung tumor on imaging
Pancoast tumor (can compress cervical sympathetic chain and cause Horner syndrome)
