Rapid Review Common Lab Findings Flashcards by Diana Mantilla

colonies of mucoid Pseudomonas in lungs

CF (AR mutation in CFTR gene> fat soluble vit def and mucous plugs in lungs)

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dec AFP in amniotic fluid/maternal serum

Downs, Edwards syndrome

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inc B-hcG, dec PAPP-A on 1st tri screening

Downs syndrome

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inc serum homocysteine, inc methylmalonic acid, dec folate

Vit B12 defec

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large granules in phagocytes, immunodeficiency

Chediak-Higashi disease (congenitfal failure of phagolysosomae fusion)

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anti-histone antibodies

drug induced SLE (hydralazine, isoniazid, phenytonin, TNFa inhibitors)

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dec T cells, dec PTH, dec Ca, absent thymic shadow

thymic aplasia (DiGeorge syndrome, velocardiofacial syndrome)

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recurrent infections, eczema, thromobocytopenia

Wiskott-Aldrich syndrome

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optochin sensitivity

sensitive: S pneumo
resistant: S viridans (S mutans, S sanguis)

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novobocin response

sensitive: S epidermis
resistant: S saprophyticus

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bacitracin response

sensitive: S pyogenes (group A)
resistant: S agalactiae (group B)

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branching gram+ rods w/ sulfur granules

Actinomyces israelli

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hilar lymphadenopathy, peripheral granulomatous lesion in middle/lower lung lobes (can calcify)

Ghon complex (1 TB: Mycobacterium bacili)

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thumb sign on lateral neck xray

epiglottitis (Hae influ)

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bacteria covered vaginal epithelial cells

“clue cells” Gardnerella vaginalis

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dilated cardiomyopathy w/ apical atrophy

Chagas Disease (Trypanosoma cruzii)

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atypical lymphocytes, heterophile antibodies

infectious mononucleosis (EBV infection)

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eosinophilic intranuclear inclusions w/ perinuclear halo

cells infected w/ Herpeseviruses (HSV, VZV, CMV)

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steeple sign on front CXR

croup (parainfluenza virus)

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eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar neurons

negri bodies of rabies (ssRNA, enveloped)
rabies> purkinjie cells of cerebellum & hippocampal neurons
RETROGRADE via dynein motors up nerve after binding nAchR» month incubation period

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psommas bodies

papillary carcinoma thyroid
meningioma
mesothelioma
papillary serous carcinoma of endometrium/ovary

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delta wave on ECG, short PR interval, supraventricular tachycardia

WPW syndrome (bundle of Kent bypasses AV node)

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boot shaped heart on Xray

ToF
1. overriding aorta
2. VSD
3. RV hypertrophy
4. pulmonary stenosis

**tet spells will exacerbate RV> episodic cyanosis
squatting: inc SVR, dec R>L shunt, improves cyanosis

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rib notching (esp inf surface on xr

coarctation of aorta

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granuloma w/ giant cells after pharyngral infection

aschoff bodies (rheumatic fever)

electrical alternans (alternating amplitude on ECG)

cardiac tamponade

enlarged thyroid cells w/ ground-glass nuclei w/ central clearing

"orphan annie" eye nuclei (papillary carcinoma of thyroid)

brown tumor of bone

hyperparathyroidism or osteitis fibrosa cystica (depositied hemosiderin from hemmhorage)

HTN, dec K, metabolic alkalosis

Conn Syndrome (1 hyperaldosteronism)

mucin-filled cell w/ peripheral nucleus

"signet ring" gastric carcinoma

anti-transglutaminase/anti-GLADIN/anti-endomysial antibodies

celiac disease (diarrhea, weight loss)

narrowing bowel lumen on barium xray

string sign (Chron's disease)

"lead pipe" appearance of colon on abd image

ulcerative colitis (loss of haustra)

thousands of polyps on colonoscopy

FAP (AD, mutation of APC gene)

apple core lesion on barium enema

colorectal cancer (gen L sided)

eosinophilic cytoplasmic inclusion in liver cell

mallory body (alcoholic liver disease)

anti-smooth muscle antibodies (ASMAs), anti-liver/kidney microsomal-1 (anti-LKM1) antibodies

autoimmune hepatitis

nutmeg appearance of liver

chronic passive congestion of liver w/ R heart failure Budd Chiari syndrome

anti-mitochondrial antibodies (AMAs)

primary biliary cholangitis (female, cholestasis, portal HTN)

low serum ceruloplasmin

wilson disease (hepatolenticular degeneration; K-F rings w/ copper accumulation)

migratory thrombophlebitis (leading to migrating DVTs and vasculitis)

trousseau syndrome (adenocarcinoma of pancreas >> lung)

hypersegmented neutrophils

megaloblastic anemia (B12: neurological symptoms) (B9: no neuro symptoms)

basophilic stippling of RBCs

lead posioning or sideroblastic anemia

hair on end "crew cut" appearance

B-thalaessemia, sickle cell disease (marrow expansion)

anti-Gp2b/3a antibodies

immune thrombocytopenia

high level D-dimers

DVT, DIC

giant B cells w/ bilobed nuceli w/ prominent inclusions

"owl's eye" Reed-Sternberg cells (Hodkin Lymphoma)

sheets of medium sized lymphoid cells w/ scattered pale, tingible body-laden macrophages

"starry sky" appearance Burkitt Lymphoma t(8, 14), c-myc activation associated with EBV they stars are the malignant cells

lytic "punched out" bone lesions on xray

monoclonal spike on serum protein electrophoresis

MM (IgG or IgA) Waldenstrom macroglobulinemia (IgM) Monoclonal gammopathy of undetermined signficiance

stacks of RBCs

rouleaux formation (high ESR, MM)

azurophilic peroxidase+ granular inclusions in granuloctyes & myeloblasts

auer rods (APL)

WBCs that smudge

CLL

"tennis racket" cytoplasmic organelles on EM

birbeck granules (langerhans cell hisiocytoes)

soap bubble in femur/tibia

giant cell tumor of bone (generally bengign)

raised periosteum "codman triangle"

agressive bone lesion (osteosarcoma, Ewing sarcoma)

onion skin periosteal rxn

Ewing sarcoma (malignant small blue cell tumor)

anti-IgG antibodies

RA (systemic inflame, joint pannus, boutonniere and swan neck deformities)

rhomboid crystals birefringent +

psuedogout (calcium pyrophosphate dihydrate crystals)

needle shapped birefringent -

gout (monosodium urate)

inc uric acid levels

gout Lesch-Nyhan syndrome tumor lysis syndrome loop/thiazide diuretics

bamboo spine

HLA B27, ankylosising spondylitis (chronic inflamed arthritis)

anti-nuclear antibodies (ANAs: anti-Smith & anti-dsDNA)

SLE (HSR 3)

perinuclear anti-neutrophil cytoplasmic antibodies (p-ANACs)

MPO-ANCA microscopic polyangitis eosinophilic granulomatosis w/ polyangitis primary sclerosisng cholangitis

cytoplasmic anti-neutrophil cytoplasmic antibodies (c-ANACs)

granulomatosis w/ polyangitis

anti-centromere antibodies

scleroderma (CREST syndrome)

anti-topoisomerase antibodies

diffuse scleroderma (more kidney/lung involvemetn)

anti-desmoglein antibodies

anti-desmosome antibodies pemphigus vulgaris (blistering)

keratin pearls

squamous cell carcinoma

inc AFP in amniotic fluid/maternal serum

dating error (most common) open neural tube defects: anencephaly, spina bifida

bloody/yellow tap lumbar puncture

xanthochromia (due to subarachnoid hemorrhage)

eosinophilic cytoplasmic inclusion in neuron

lewy body (parkinson disease + lewy body dementia)

extracellular amyloid deposition in gray matter of brain

senile plaques (Alzheimer disease)

depigmentation of neurons in SN

parkinson disease (basal ganglia disorder: rigidty, resting tremor, bradykinesia)

protein aggregates in neurons from hyperphosphorylation of tau protein

neurfibrillary tangles of Alz Disease or Pick bodies (Pick Disease)

pseudopalisading pleomorphic tumor cells on brain biopsy

glioblastoma multiforme

silver-staining spherical aggreation of tau proteins in neurons

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

circular grouping of dark tumor cells surround pale neurofibrils

Homer-Wright rosettes (neuroblastoma, medulloblastoma)

waxy casts w/ low urine flow

chronic end stage renal disease

WBC casts in urine

acute pyelonephritis transplant rejection tubulointerstital inflammation

RBC casts in urine

glomerulonephritis

tram track appearance of capillary loops of glomerular basement membranes on light microscopy

membranoproliferative glomerulonephritis

anti-glomerular basement membrane antibodies

goodpasture syndrome (glomerulonephritis + hempotysis)

ceullar crescents in bowman capsule

rapidly progressive glomerulonephritis

wire loop glomerular capillary appearance on ight micro

diffuse proliferative glomerulonephritis (usually w/ lupus)

linear IgG appearance on glomerular basement membrane

Goodpasture syndrome

"lumpy bumpy" appearance of glomeruli on IM

poststreptococcal glomerulonephritis (IgG, IgM, C3 deposition)

necrotizing vasculitis (lungs) + necrotizing glomerulonephritis

granulomatosis w/ polyangiitis (c-ANCA) Goodpasture syndrome (anti-BM antibodies)

nodular hyaline deposits in glomeruli

Kimmelstiel-Wilson nodules (diabetic nephropathy)

podycyte fusion/effacement on EM

minimal change disease (child w/ nephrotic syndrome)

spikes on BM, domes on subepithelial deposits

membraneous nephropathy (nephrotic)

thyroid-like appearance of kidney

chronic pyelonephritis (usually recurrent infection)

granular casts in urine

acute tubular necrosis (ischemia/toxic injury)

hCG elevated

multiple gestations hydatidiform moles choricocarcinomas Down syndrome

dysplastic squamous cervical cells w/ "rasinoid" nuclei & hyperchromasia

koilocytes (HPV: predisposes to cervical cancer)

sheets of uniform "fried egg" cells, inc hCG, inc LDH

dysgerminoma

disarrayed granulosa cells arranged around collections of eosinophilic fluid

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

chocolate cyst of ovary

endometriosis (frequently both ovaries)

mammary gland "blue domed" cysts

fibrocystic change of breast

glomerulus-like structure surrounding vessel in germ cells

schiller-duval bodies (yolk sac tumor)

rectangular, crystal-like, cytoplasmic inclusions in Leydig cells

Reinke cells (Leydig cell tumors)

thrombi made of white/red layers

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

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

bronchial asthma (Charcot-layden crystals: eosinophilic granules)

desquamated epithelium casts in sputum

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

"honeycumb" lung on CT/Xray

idiopathic pulmonary fibrosis

iron-containing nodules in alveolar septum

ferruginous bodies (asbestosis: inc lung cancer risk)

bronchogenic apical lung tumor on imaging

pancoast tumor (can compress cervical symp chain ganglia> Horner syndrome)