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Flashcards in Rapid Review - Classic Labs Findings Deck (113):
1

Anti-centromere Ab

Scleroderma (CREST)

2

Anti-desmoglein (epithelial) Ab

Pemphigus vulgaris

3

Anti-glomerular basement membrane Ab

Goodpasture syndrome

4

Anti-histone Ab

Drug-induced SLE

5

Anti-IgG Ab

Rheumatoid Arthritis

6

Anti-mitochrondial Ab

Primary Biliary Cirrhosis (female, cholestasis, portal HTN)

7

ANCAs

Granulomatosis with polyangiitis (Wegeners, PR3-ANCA, c-ANCA)Microscopic Polyangiitis (MPO-ANCA, p-ANCA)Churg Strauss (MPO-ANCA, p-ANCA)

8

Antinuclear Ab, Anti-Smith, Anti-dsDNA

SLE (type III hypersensitivity)

9

Antiplatelet Ab

Idiopathic thrombocytopenic purpura

10

Anti-topoisomerase Ab

Diffuse, systemic scleroderma

11

Anti-transglutaminase, Anti-gliadin, Anti-endomysial Ab

Celiac disease (diarrhea, distention, weight loss)

12

"Apple core" on abdominal X-ray

Colorectal cancer (usually left-sided)

13

Azurophilic peroxidase + granular inclusions in granulocytes and myeloblasts

Auer Rods in AML (especially promyelocytic M3 type)

14

Bacitracin response

Resistant: Group B Strep (agalactiae)Sensitive: Group A Strep (pyogenes)Mnemonic: B-BRAS

15

Bamboo spine on X-ray

Ankylosing spondylitis (chronic inflammatory arthritis, HLA-B27)

16

Basophilic nuclear remnants in RBC

Howell-Jolly bodies (due to splenectomy or dysfunctioning spleen)

17

Basophilic stippling on RBC

Lead poisoning, sideroblastic anemia

18

Bloody tap on LP

Subarachnoid Hemorrhage

19

Boot-shaped heart on CXR

Tetralogy of Fallot, RVH

20

Branching gram+ rods with sulfur granules

Actinomyces israelii (anaerobe)

21

Bronchogenic apical lung tumor on imaging

Pancoast tumor (can compress sympathetic ganglion -> Horner Syndrome) (can also compress the brachial plexus)

22

"Brown" tumor of bone

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

23

Cardiomegaly with apical atrophy

Chagas disease (Trypanosoma cruzi)

24

Cellular crescents in Bowman capsule

Rapidly progressive glomerulonephritis (RPGN)

25

Chocolate cysts in ovary

Endometriosis, frequently involves both ovaries.

26

Circular grouping of dark tumor cells around pale neurofibrils

Homer-Wright rosettes (neuroblastoma, medulloblastoma, retinoblastoma)

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 abnormality

29

Degeneration of the dorsal column nerves

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

30

Depigmentation of neurons in the substantia nigra

Parkinsons (basal ganglia disorder: rigidity, resting tremor, bradykinesia)

31

Desquamated epithelium casts in sputum

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

32

Disarrayed granulosa cells in eosinophilic fluid

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

33

Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia

Koilocytes (HPV: predisposes to cervical cancer)

34

Enlarged cells with intranuclear inclusion bodies

Owl eye appearance of CMV

35

Enlarged thyroid cells with ground glass nuclei

Orphan Annie eyes nuclei - papillary carcinoma of the thyroid

36

Eosinophilic cytoplasmic inclusion in liver cell

Mallory Body (alcoholic liver disease)

37

Eosinophilic inclusion body in nerve cell

Lewy body (Parkinson disease)

38

Eosinophilic globule in liver

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

39

Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar nerve cells

Negri bodies of rabies

40

Extracellular amyloid deposition in gray matter of the brain

Senile plaques (Alzheimers disease)

41

Giant B cells with bilobed nuclei with prominent inclusions (Owl's eye)

Reed Sternberg cells, (Hodgkin lymphoma)

42

Glomerulus-like structure surrounding vessels in germ cell

Schiller-Duval bodies (yolk sac tumor AKA endodermal sinus tumor)

43

Hair on end (crew-cut) appearance on X-ray

Beta-thalassemia, sickle cell anemia - due to marrow expansion.

44

beta-hCG elevations

Choriocarcinoma, hydatidiform mole (occurs with and without embryo, and multiple pregnancy)Extra note: Can also see increase in 1st and 2nd trimester of Down syndrome (as opposed to general decreases in free beta-hCG in Trisomy 18 and 13)

45

Cart nodules (granulomatous)

Aschoff bodies (rheumatoid fever)

46

Heterophile Antibodies

EBV, Infectious mononucleosis

47

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

Bronchial asthma (Charcot leyden crystals: eosinophilic granules)

48

High level of D-dimers

DVT, PE, DIC

49

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

Ghon complex (primary TB infection)

50

"Honeycomb lung" on CXR or CT

Interstitial pulmonary fibrosis

51

Hypercoagulability (leading to migrating DVTs and vasculitis)

Trousseau syndrome (adenocarcinoma of pancreas or lung)

52

Hypersegmented neutrophils

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

53

Hypertension, hypokalemia, metabolic alkalosis

Conn syndrome (aldosterone-producing adenoma)

54

Hypochromic, microcytic anemia

Iron deficiency anemia, lead poisoning, thalassemia (fetal Hb sometimes present)

55

Increased AFP in amniotic fluid/maternal serum

Dating error usually, anencephaly, spina bifida (neural tube defects)

56

Increased uric acid levels

Gout, Lesch-Nyhan Syndrome, tumor lysis syndrome, loop and thiazide diuretics

57

Intranuclear cytoplasmic droplet-like bodies

Cowdry type A bodies (HSV or CMV)

58

Iron-containing nodules in alveolar septum

Ferruginous bodies (asbestosis: increases chances of mesothelioma)

59

Keratin pearls on a skin biopsy

Squamous cell carcinoma

60

Large lysosomal vesicles in phagocytes, immunodeficiency

Chediak-Higashi disease (congenital failure of phagolysosome formation)

61

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

Ulcerative Colitis, due to loss of haustra

62

Linear appearance of IgG deposition on glomerular basement membrane

Goodpasture syndrome

63

Low serum ceruloplasmin

Wilson disease (hepatolenticular degeneration)

64

"Lumpy bumpy" appearance of glomeruli on immunofluorescence

Post-strep glomerulonephritis (PSGN) (immune complex formation of IgG and C3b)

65

Lytic (hole-punched) lesions on bones in X-ray

Multiple myeloma

66

Mammary gland ("blue domed") cyst

Fibrocystic change of the breast

67

Monoclonal antibody spike

- Multiple Myeloma (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" of gastric carcinoma

69

Narrowing of bowel lumen on barium x-ray

String sign, Crohn's disease

70

Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis

Granulomatosis with polyangiitis (Wegener, anti-PR3, c-ANCA), and Goodpasteur syndrome (anti-basement membrane Ab)

71

Needle-shaped, negatively birefringent crystals

Gout (monosodium urate crystals)

72

Nodular hyaline deposits in glomeruli

Kimmelstiel-Wilson nodules (diabetic nephropathy)

73

Novobiocin response

Resistant: Staph saprophyticusSensitive: Staph epidermidis"NO StRESs"

74

"Nutmeg" appearance of liver

Chronic passive congestion of liver during right heart CHF

75

"Onion skin" periosteal reaction

Ewing sarcoma (malignant round-cell tumor)

76

Optochin Response

Resistant: Strep viridansSensitive: Strep pneumoOVRPS (overpass)

77

Periosteum raised from bone, creating triangular area

Codman triangle (osteosarcoma, ewing sarcoma, pyogenic osteomyelitis)

78

Podocyte fusion or effacement on EM

Minimal change disease (child with nephrotic syndrome)

79

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

Eburnation (Osteoarthritis resultign in bony sclerosis)

80

Protein aggregates in neurons from hyperphosphorylation of tau protein

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

81

Psammoma bodies

Meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of the endometrium and ovary

82

Pseudopalisading tumor cells on brain biopsy

Glioblastoma multiforme (GBM)

83

RBC Casts in urine

Acute glomerulonephritis

84

Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells

Reinke crystals (Leydig cell tumor)

85

Renal epithelial casts in urine

Acute toxic/viral renal injury

86

Rhomboid crystals, positively birefringent

Pseudogout (calcium pyrophosphate dihydrate crystals)

87

Rib notching

Coarctation of the aorta

88

Ring-enhancing brain lesion in AIDS

Toxoplasma gondii, CNS lymphoma

89

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

Burkitt lymphoma (t[8;14] c-myc activation, associated with EBV; "black sky" consists of malignant cells)

90

Silver-staining spherical aggregation of tau proteins in neurons

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

91

Soap bubble in femur or tibia on X-ray

Giant cell tumor of bone (generally benign)

92

Spikes on basement membrane, dome-like subepithelial deposits

Membranous glomerulonephritis (may progress to nephrotic syndrome)

93

Stacks of RBCs

Rouleaux formation (high ESR, multiple myeloma)

94

Stippled vaginal epithelia

Clue cells (gardnerella vaginalis infection)

95

Tennis racket shapred cytoplasmic organelles (EM) in langerhans cells

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

96

Thrombi made of white/red layers

Lines of Zahn (arterial thrombus, layers of platelets and RBCs; implies that thrombosis occurred before death)

97

Thumb sign on lateral x-ray

Epiglottitis (H flu infection)

98

Thyroid-like appearance of kidney

Chronic bacterial pyelonephritis

99

Tram-track appearance of capillary loops of glomerular BM on light microscopy

MPGN

100

Triglyceride accumulation in liver cell vacuoles

Fatty liver disease (alcoholic or metabolic syndromes)

101

Waxy casts with very low urine flow

Chronic end-stage renal disease

102

WBC casts in urine

Acute pyelonephritis

103

WBCs that look smudged

CLL (almost always B cell)

104

Wire loop glomerular capillary appearance on light microscopy

Lupus nephropathy

105

Yellowish CSF

Xanthochromia (blood in CSF due to SAH)

106

Antibody to Phospholipase-A2 receptor

Membranous nephropathy (IgG4)

107

RBCs stacked together in long chains

Rouleaux formation (Multiple Myeloma)

108

Sucrose screening test for activation of complement

Paroxysmal nocturnal hemoglobinuria. Confirmatory tests are flow cytometry of DAF presence (CD55) on RBC or acidified serum test

109

Reddish, pink periodic acid-Schiff positive granules in periportal hepatocytes

Alpha-1-Anti-trypsin deficiency (stuck in granules, unsecreted)

110

Alveolar cells with golden cytoplasmic granules that stain dark blue with Prussian blue staining

Heart failure cells with hemosiderin (macrophages, indicating pulmonary congestion and edema due to left CHF)

111

Skin biopsy with intranuclear inclusions in keratinocytes and multinucleated giant cells.

Positive Tzanck smear - VZV, HSV

112

Positive Sodium cyanide-nitroprusside test (turns red-purple in color)

Detects sulfhydryl groups (presence of cystine in urine -- cystinuria, AR defect of renal proximal tubules (COLA transport))

113

Temporoparietal lobe and/or hippocampal atrophy

Alzheimers