Classic Labs/findings Flashcards
(110 cards)
1
Q
Down syndrome, Edward syndrome
A
LOW AFP in amniotic fluid/maternal serum
2
Q
Chediak Higashi disease (congenital failure of phagolysosome formation)
A
Large granules in phagocytes
Immunodeficiency
3
Q
Wiskott Aldrich syndrome
A
Recurrent infections
Eczema
Thrombocytopenia
4
Q
Optochin sensitive
A
Streptococcus pneumoniae
5
Q
Optichin RESISTANT
A
Viridans streptococci
- S mutans
- S sanguis
6
Q
Novobiocin sensitive
A
Staphylococcus epidermidis
7
Q
Novobiocin resistant
A
Staphylococcus saprophyticus
8
Q
Bacitracin sensitive
A
Streptococcus pyogenes (group A)
9
Q
Bacitracin resistant
A
Streptococcus agalactiae (group B)
10
Q
Colon cancer
A
Streptococcus bovis bacteremia
11
Q
Actinomyces israelii
A
Branching gram + rods with sulfur granules
12
Q
Ghon complex (primary TB Mycobacterium bacilli)
A
Hilar lymphadenopathy AND Peripheral granulomatous lesion in middle or lower lung lobes (can calcify)
13
Q
Epiglottitis (Haemophilus influenzae)
A
“Thumb sign” on lateral neck XR
14
Q
Clue cells (Gardnerella vaginalis)
A
Bacteria covered vagina epithelial cells
15
Q
Chagas’ disease (Trypanosoma cruzi)
A
Dilated cardiomyopathy with apical atrophy
MEGACOLON
MEGAESOPHAGUS
South America
Romana sign- unilateral periorbital swelling
16
Q
Epstein Barr Virus
A
Atypical lymphocytes
17
Q
“Owl eye” appearance of CMV
A
Enlarged cells with intranuclear inclusion bodies
18
Q
Infectious mononucleosis (EBV)
A
Heterophile antibodies
19
Q
Cowdry Type A bodies (HSV or VZV)
A
Intranuclear eosinophilic droplet like bodies
20
Q
Councilman body (viral hepatitis, yellow fever), represents hepatocyte undergoing apoptosis
A
Eosinophilic globule in liver
21
Q
Croup (parainfluenza virus)
A
“Steeple sign” on frontal CXR
22
Q
Negri bodies of rabies
A
Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar neurons
23
Q
Toxoplasma gondii, CNS lymphoma
A
Ring enhancing bran lesion on CT/MRI in AIDS
24
Q
Meningiommas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of endometrium and ovary
A
Psamomma bodies
25
Wolff Parkinson White syndrome (bundle of Kent bypasses AV node)
“Delta wave” on EKG, short PR interval, supraventricular tachycardia
26
Tetralogy of Fallot (d/t RVH)
“Boot shaped” heart on CXR
27
Coarctation of the aorta
Rib notching (inferior surface on XR)
28
Aschoff bodies (rheumatic fever)
Heart nodules (granulomatous)
29
Cardiac tamponade
Electrical alternans (alternating amplitude on EKG)
30
1. Microscopic polyangiitis and eosinophilic granulomatosis with polyangiitis (MPO-ANCA/p-ANCA)
2. Granulomatosis with polyangiitis (Wegener; PR3 ANCA/c-ANCA
3. Primary sclerosing cholangitis (MPO-ANCA/p-ANCA)
Antineutrophil cyroplasmic antibodies (ANCAs)
31
Primary hyperaldosteronism (Conn syndrome)
HTN
Hypokalemia
Metabolic alkalosis
32
“Orphan Annie” eyes nuclei (papillary carcinoma of thyroid)
Enlarged thyroid cells with ground glass nuclei with central clearing
33
Signet ring (diffuse gastric carcinoma)
Mucin filled cell with peripheral nucleus
34
Celiac disease (diarrhea, weight loss)
Anti transglutaminase/anti gliadin/anti endomysial antibodies
35
String sign (Crohn disease)
Narrowing of bowel lumen barium x Ray
36
Ulcerative colitis (loss of haustra)
Lead pipe appearance of colon on abdominal imaging
37
Familial adenomatous polyposis (autosomal dominant, mutation of APC gene)
Thousands of polyps on colonoscopy
| 100% progression to colon cancer
38
Colorectal cancer (usually left sided)
“Apple core” lesion on barium enema
39
Mallory body (alcoholic liver disease)
Eosinophilic cytoplasmic inclusions of damaged keratin filaments in liver cell
40
Fatty liver disease (alcoholic or metabolic syndrome)
Triglyceride accumulation in liver cell vacuoles
| Cellular “ballooning”
41
Chronic passive congestion of liver d/t RHF or Budd Chiari syndrome
Nutmeg appearance of liver
42
Primary biliary cholangitis (female, cholestasis, portal HTN)
Anti mitochondrial antibodies(AMAs)
43
Wilson disease (hepatolenticular degeneration, Kayser Fleischer rings due to copper accumulation)
Low ceruloplasmin
44
Trousseau syndrome (adenocarcinoma of pancreas or lung)
Migratory thrombophlebitis (leading to migrating DVTs and vasculitis)
45
Howell Jolly bodies (due to splenectomy or non functional spleen)
Basophilic nuclear remnants in RBCs
46
Lead poisoning or sideroblastic anemia
Basophilic stippling of RBCs
47
Iron deficiency anemia, lead poisoning, thalassemia (fetal hemoglobin sometimes present)
Hypochromic, microcytic anemia
48
Beta thalassemia, sickle cell disease (bone marrow expansion)
Hair on end, crew cut appearance on x Ray
49
Megaloblastic anemia (B12 deficiency: neurological symptoms, folate deficiency: no neuro symptoms)
Hypersegmented neutrophils
50
Idiopathic thrombocytopenia purpura
Anti platelet antibodies
51
DVT, PE, DIC
High level of D dimers
52
Reed Sternberg cells (Hodgkin lymphoma)
Giant B cells with bilobed nuclei with prominent inclusions (owl’s eye)
53
Burkitt lymphoma (t[8:14], c myc activation, ASSOC W EBV: “starry sky” made up of malignant cells”
Sheets of medium sized lymphoid cells with scattered pale, tingible body-laden macrophages (“starry sky histology”)
54
Multiple myeloma
Lytic “punched out” bone lesions on x Ray
55
1. Multiple myeloma (usually IgG or IgA)
2. Monoclonal gammopathy of undetermined significance (MGUS consequence of aging)
3. Walden storm (M protein = IgM) macroglobulinemia
4. Primary amyloidosis
Monoclonal antibody spike
56
Rouleaux formation (high ESR, multiple myeloma)
Stacks of RBCs
57
Auer rods (AML, esp promyelocytic M3 type)
Azurophilic peroxidase + granular inclusions in granulocytes and myeloblasts
58
CLL (almost always B cell)
WBCs that look “smudged”
| Crushed Little Lymphocytes
59
Birbeck granules (Langerhans histiocytosis)
Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells
60
Hyperparathyroidism or osteitis fibrosis cystica (deposited hemosiderin from hemorrhage gives brown color)
“Brown” tumor of bone
61
Giant cell tumor of bone (usually benign)
“Soap bubble” in femur or tibia on x Ray
62
Aggressive bone lesion (osteosarcoma, Ewing sarcoma, osteomyelitis)
Raised periosteum (creating Codman’s triangle)
63
Ewing sarcoma (malignant small blue cell tumor)
Onion skin periosteal reaction
64
Rheumatoid arthritis (systemic inflammation, joint pannus, boutonniere and swan neck deformities)
HLA DR4
+ rheumatoid factor (IgM antibody that targets IgG Fc region), anti IgG
+ anti cyclic citrullinated peptide (anti CCP)- more specific
65
Pseudogout (calcium pyrophosphate dihydrate crystals)
Rhomboid crystals, + birefringement
66
Gout (monosodium urate crystals)
Needle shaped
| - birefringement crystals
67
Gout
Lesch Nyhan syndrome
Tumor lysis syndrome
Loop and thiazides diuretics
High uric acid levels
68
Ankylosing spondylitis (chronic inflammatory arthritis, HLA B27)
Bamboo spine on x Ray
69
SLE (type III HSR)
Anti nuclear antibodies (ANAs: anti Smith and anti dsDNA)
70
Drug induced SLE (hydralazine, INH, procainamide, phenytoin)
Anti histone antibodies
71
Diffuse scleroderma
Anti topoisomerase antibodies
72
Squamous cell carcinoma (skin bx)
Keratin pearls on skin bx
73
Xanthochromia (due to subarachnoid hemorrhage)
Bloody or yellow tap on lumbar puncture
74
Lewy body (Parkinson disease and Lewy body dementia)
Eosinophilic cytoplasmic inclusion in neuron
75
Senile plaques (Alzheimer’s disease)
Extra cellular amyloid deposition in grey matter
76
Parkinson disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia)
Depigmentation of neurons in substantial nigra
77
Neurofibrillary tangles (Alzheimer’s disease) and Pick bodies (Pick disease)
Protein aggregates in neurons from hyperphosphorylation of TAU protein
78
Pick bodies (Pick disease: progressive dementia, changes in personality)
Silver staining spherical aggregation of tau proteins in neurons
79
Glioblastoma multiforme
Pseudopalisading tumor cells on brain biopsy
80
Homer Wright rosettes (neuroblastoma, medullablastoma)
Circulating grouping of dark tumor cells surrounding pale neurofibrils
81
Chronic end stage renal disease
WAXY CASTSwith very low urine flow
82
Kimmelstein Wilson nodules (diabetic nephropathy)
Nodular hyaline deposits in glomeruli
83
Minimal change disease (child with nephrotic syndrome)
Podocyte fusion or “effacement” on electron microscopy
84
Membranous nephropathy (nephrotic syndrome)
“SPIKES” on basement membrane, “DOME LIKE” subepithelial deposits
85
Glomerulonephritis
RBC casts in urine
86
Membranoproliferative glomerulonephritis
TRAM TRACK appearance of capillary loops of gomerular basement membranes on LM
87
Goodpasture syndrome (glomerulonephritis AND hemoptysis)
Anti glomerular basement membrane antibodies
88
Rapidly progressive (crescentic) glomerulonephritis
Cellular crescents in Bowman capsule
89
Diffuse proliferative glomerulonephritis (usually seen with lupus)
WIRE LOOP glomerular capillary appearance on LM
90
Goodpasture syndrome
LINEAR appearance of IgG deposition on glomerular AND alveolar basement membranes
91
Poststreptococcal glomerulanephritis (dt deposition of IgG, IgM, C3)
LUMPY BUMPY appearance of glomeruli on immunofluorescence
92
Granulomatosis with polyangiitis (Wegener PR3-ANCA/c-ANCA) and Goodpasture syndrome (anti basement antibodies)
Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis
93
Chronic pyelonephritis (dt recurrent infections)
Thyroid like appearance of kidney
94
Acute pyelonephritis
WBC casts in urine
95
Intrinsic renal failure (ischemia, toxic injury)
Renal epithelial casts in urine
96
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Choriocarcinoma
Hydatiform mole (occurs with and without embryo, and multiple pregnancy)
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hCG elevated
97
Koilocytes (HPV: predisposes to cervical cancer)
Dysplastic squamous cervical cells with “raisonoid” nuclei and hyperchromasia
98
Call Exner bodies (granulosa cell tumor from ovary)
Disarrayed granulosa cells arranged around collections of eosinophilic fluid
99
Endometriosis (involves both ovaries)
“Chocolate cyst” of ovary
100
Fibrocystic changes of breast
Mammary gland (blue domed) cyst
101
Schiller Duval bodies (yolk sac tumor)
Glomerulus like structure surrounding vessel in germ cells
102
Reinke crystals (Leydig cell tumor)
Rectangular crystal like cytoplasmic inclusions in Leydig cells
103
Lines of Zahn (arterial thrombus, layers of platelets/RBCs)
Thrombi made of red and white layers
104
Bronchial asthma (Charcot Leyden crystals: eosinophilic granules)
Hexagonal double pointed needle like crystals in bronchial secretions
105
Curschmann spirals (bronchial asthma, can result in whorled mucus plugs)
Desquamated epithelium casts in sputum
106
Idiopathic pulmonary fibrosis
Honey comb lung on CXR/CT
107
Cystic fibrosis (AR mutation in CFTR gene-> fat soluble vitamin deficiency and mucus plugs)
Colonies of mucous Pseudomonas in lungs
108
Ferruginous bodies (asbestos; HIGH chance of lung cancer)
Iron containing nodules in alveolar sputum
109
Pancoast tumor (can compress cervical sympathetic chain and cause Horner syndrome)
Bronchiogenic apical lung tumor on imaging
110
Aldosterone MOA
Inserts Na channels and Nak ATPase in principal cell in collecting duct
More Na pulled back into interstitium and more K goes out in urine
Printed insertion of H pumps into intercalated cells, promote H excretion into urine
