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Flashcards in Rapid Review: Classic Labs/Findings Deck (105):
1

Anticentromere antibodies

Scleroderma (CREST)

2

Antidesmoglein (epithelial) antibodies

Pemphigus vulgaris (blistering)

3

Anti-glomerular basement membrane antibodies

Goodpasture's syndrome (glomerulonephritis and hemoptysis)

4

Antihistone antibodies

Drug-induced SLE (hydralazine, isoniazid, phenytoin, procainamide)

5

Anti-IgG antibodies

RA (systemic inflammation, joint pannus, boutonniere deformity)

6

Antimitochondrial antibodies (AMAs)

Primary biliary cirrhosis (female, cholestasis, portal hypertension)

7

Antineutrophil cytoplasmic antibodies (ANCAs)

Vasculitis (c-ANCA: granulomatosis with polyangitis [Wegener's]; p-ANCA: microscopic polyangitis, Churg-Strauss syndrome)

8

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

SLE (type III hypersensitivity)

9

Antiplatelet antibodies

Idiopathic thrombocytopenic purpura

10

Anti-topoisomerase antibodies

Diffuse systemic scleroderma

11

Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies

Celiac disease (diarrhea, distention, weight loss)

12

Apple core lesion on abdominal x-ray

Colorectal cancer (usually left sided)

13

Azurophilic peroxidase-positive granular inclusions in granulocytes and myeloblasts

Auer rods (AML, especially the promyelocytic [M3] type)

14

Bacitracin response

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

15

Bamboo spine on x-ray

Ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27)

16

Basophilic nuclear remnants in RBCs

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

17

Basophilic stippling of RBCs

Lead poisoning or sideroblastic anemia

18

Bloody tap on LP

Subarachnoid hemorrhage

19

Boot shaped heart on x-ray

Tetrology of Fallot, RVH

20

Branching gram-positive rods with sulfur granules

Actinomyces israelii

21

Bronchogentic apical lung tumor on imaging

Pancoast tumor (can compress sympathetic ganglion and cause Horner's syndrome)

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's capsule

Rapidly progressive crescentic glomerulonephritis

25

Chocolate cyst of ovary

Endometriosis (frequently involves both ovaries)

26

Circular grouping of dark tumor cells surrounding pale neurofibrils

Homer-Wright rosettes (neuroblastoma, medulloblastoma, retinoblastoma)

27

Colonies of mucoid Pseudomonas in lungs

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

28

Decreased alpha-fetoprotein in amniotic fluid/maternal serum

Down syndrome or other chromosomal abnormality

29

Degeneration of dorsal column nerves

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

30

Depigmentation of neurons in substantia nigra

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

31

Desquamated epithelium casts in sputum

Curschmann's 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's eye appearance of CMV

35

Enlarged thyroid cells with ground-glass nuclei

orphan Annie's eyes nuclei (papillary carcinoma of the thyroid)

36

Eosinophilic cytoplasmic inclusion in liver cell

Mallory bodies (alcoholic liver disease)

37

Eosinophilic cytoplasmic inclusion in nerve cell

Lewy body (Parkinson's disease)

38

Eosinophilic globule in liver

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

39

Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells

Negri bodies of rabies (Lyssavirus)

40

Extracellular amyloid deposition in gray matter of brain

Senile plaques (Alzheimer's disease)

41

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

Reed-Sternberg cells (Hodgkin's lymphoma)

42

Glomerulus-like structure surrounding vessel in germ cells

Schiller-Duval bodies (yolk sac tumor)

43

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

Beta-thalassemia, sickle cell anemia (marrow expansion)

44

hCG elevated

Choriocarcinoma, hydatidiform mole (occurs with and without embyro)

45

Heart nodules (granulmatous)

Aschoff bodies (rheumatic fever)

46

Heterophile antibodies

Infectious mononucleosis (EBV)

47

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

Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)

48

High levels of D-dimers

DVT, pulmonary embolism, DIC

49

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

Ghon complex (primary TBL mycobacterium bacilli)

50

Honeycomb lung on x-ray or CT

Interstitial pulmonary fibrosis

51

Hypercoagulability (leading to migrating DVTs and vasculities)

Trousseau's syndrome (adenocarcinoma of pancreas or lung)

52

Hypersegmented neutrophils

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

53

Hypertension, hypokalemia, metabolic alkalosis

Conn's syndrome

54

Hypochromic, microcytic anemia

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

55

Increased alpha-fetoprotein in amniotic fluid/maternal serum

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

56

Increased uric acid levels

Gout, Lesch-Nyan syndrome, tumor lysis syndrome, loop and thiazide diuretics

57

Intranuclear eosinophilic droplet-like bodies

Cowdry type A bodies (HSV or CMV)

58

Iron-containing nodules in alveolar septum

Ferruginous bodies (asbestosis: increased chance or 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 (loss of haustra)

62

Linear appearance of IgG deposition on glomerular basement membrane

Goodpasture's syndrome

63

Low serum ceruloplasmin

Wilson's disease (hepatolenticular degeneration)

64

Lumpy bumpy appearance of glomeruli on immunofluorescence

Poststreptococcal glomerulonephritis (immune complex deposition of IgG and C3b)

65

Lytic (hole punched) bone lesions on x-ray

Multiple myeloma

66

Mammary gland (blue domed) cyst

Fibrocystic changes of the breast

67

Monoclonal antibody spike

- Multiple myeloma (usually IgG or IgA)
- Monoclonal gammopathy of undetermined significance (MGUS; normal consequence of aging)
- Waldenstrom's (M protein = IgM) macroglobulinemia
- Primary amyloidosis

68

Mucin-filled cell with peripheral nucleus

Signet ring (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 polyangitis (wegener's: c-ANCA positive) and Goodpasture's syndrome (anti-basement membrane antibodies)

71

Needle-shaped, negatively birefringent crystals

Gout (monosodium urate crystals)

72

Nodular hyaline deposits in glomeruli

Kimmelstiel-Wilson nodules (diabetic nephropathy)

73

Novobiocin response

Sensitive: Staphylococcus epidermidis; resistant: Staphylococcus saprophyticus

74

Nutmeg appearance of liver

Chronic passive congestion of liver due to right heart failure

75

Onion skin periosteal reaction

Ewing's sarcoma (malignant round-cell tumor)

76

Optochin response

Sensitive: Streptococcus pneumoniae; resistant: Viridans streptococcus

77

Periosteum raised from bone, creating triangular area

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

78

Podocyte fusion or effacement on electron microscopy

Minimal change disease (child with nephrotic syndrome)

79

Polished, ivory like appearance of bone at cartilage erosion

Eburnation (osteoarthritis resulting in bony sclerosis)

80

Protein aggregates in neurons from hyperphosphylation of protein tau

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

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 nephrosis

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 histology)

Burkitt's lymphoma (t[8:14] c-myc activation, associated with EBV; black sky made up of malignant cells)

90

Silver-staining spherical aggregation of tau proteins in neurons

Pick bodies (Pick's 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 epithelial cells

Clue cells (gardnerella vaginalis)

95

Tennis racket shaped cytoplasmic organelles (EM) in Langerhans cells

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

96

Thrombi made of white/red layers

lines of Zahn (arterial thrombus, layers of platelets/RBCs)

97

Thumb sign on lateral x-ray

Epiglottitis (H. influenzae)

98

Thyroid like appearance of kidney

Chronic bacterial pyelonephritis

99

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

Membranoproliferative glomerulonephritis

100

Triglyceride accumulation in liver cell vacoules

Fatty liver disease (alcoholic or metabolic syndrome)

101

Waxy casts with very low urine flow

Chronic ESRD

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 nephrophathy

105

Yellowish CSF

Xanthochromia (eg due to subarachnoid hemorrhage)

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