RR - labs and diangostic findings Flashcards
(105 cards)
1
Q
Anticentromere antibodies
A
Scleroderma (CREST)
2
Q
Antidesmoglein (epithelial) antibodies
A
Pemphigus vulgaris (blistering)
3
Q
Anti-glomerular basement membrane antibodies
A
Goodpasture’s syndrome (glomerulonephritis with hemoptysis)
4
Q
Antihistone antibodies
A
Drug-induced SLE (sulfa, hydralazine, isoniazid, phenytoin, procainamide)
5
Q
Anti-IgG antibodies
A
Rheumatoid arthritis (systemic inflammation, joint pannus, boutonniere deformity)
6
Q
Antimitochondrial antibodies (AMAs)
A
Primary biliary cirrhosis (female, cholestasis, portal HTN)
7
Q
Antineutrophil cytoplasmic antibodies (ANCAs)
A
Vasculitis (c-ANCA for Wegener’s GPA), p-ANCA for microscopic polyangiitis, Churg-Strauss)
8
Q
Antinuclear antibodies (ANAs)
A
SLE (type III hypersensitivity), including anti-Smith and anti-dsDNA)
9
Q
Antiplatelet antibodies
A
Idiopathic thrombocytopenic purpura
10
Q
Anti-topoisomerase antibodies
A
Diffuse systemic scleroderma
11
Q
Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies
A
Celiac disease (diarrhea, distension, weight loss)
12
Q
Apple core lesion on abdominal x-ray
A
Colorectal cancer (usually left sided)
13
Q
Azurophilic peroxidase-positive granular inclusions in granulocytes and myeloblasts
A
Auer rods (AML, especially the promyelocytic [M3] type)
14
Q
Bacitracin response
A
Sensitive: S. pyogenes (group A), reisistant: S. agalactiae (group B)
15
Q
Bamboo spine on XR
A
Ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27)
16
Q
Basophilic nuclear remnants in RBCs
A
Howell-Jolly bodies (due to splenectomy or nonfunctional spleen)
17
Q
Basophilic stippling of RBCs
A
Lead poisoning or sideroblastic anemia
18
Q
Bloody tap on LP
A
Subarachnoid hemorrhage
19
Q
Boot shaped heart on XR
A
Tetralogy of Fallot, RVH
20
Q
Branching gram positive rods with sulfur granules
A
Actinomyces israelii
21
Q
Bronchogenic apical lung tumor on imaging
A
Pancoast tumor (can compress sympathetic ganglion and cause Horner’s)
22
Q
Brown tumor of bone
A
Hyperparathyroidism or osteitis fibrosa cystica (deposited hemosiderin from hemorrhages gives brown color)
23
Q
Cardiomegaly with apical atrophy
A
Chagas’ disease (Trypanosoma cruzi)
24
Q
Cellular crescents in Bowman’s capsule
A
RPGN
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 a-fetoprotein in amniotic fluid/maternal serum
Down syndrome or other chromosomal abnormality
29
Degeneration of dorsal column nerves
Tabes dorsalis (3o syphilis), subacute combined degeneration (dorsal columns and lateral cortiospinal 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 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 eyes nuclei (papillary thyroid carcinoma)
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)
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 XR
B-thalassemia, sickle cell anemia (marrow expansion)
44
hCG elevation
choriocarcinoma, hydatidiform mole (occurs with and without embryo)
45
Heart nodules (granulomatous)
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 level of D-dimers
DVT, pulmonary embolism, DIC
49
Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lobe of lung (can calcify)
Ghon complex (primary TB)
50
Honeycomb lung on XR or CT
Interstitial pulmonary fibrosis
51
Hypercoagulability (leading to migrating DVTs and vasculitis)
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, lead poisoning, thalassemia (fetal hemoglobin sometimes present)
55
Increased a-fetoprotein in amniotic fluid/maternal serum
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Dating error, anencephaly, spina bifida (neural tube defects)
Ataxia telangiectasia (not pregnant but just remember)
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56
Increased uric acid levels
Gout, Lesch-Nyhan, 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 of mesothelioma)
59
Keratin pearls on 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 XR
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 GN (immune complex deposition of IgG and C3b)
65
Lytic "hole punched" bone lesions on XR
Multiple myeloma
66
Mammary gland "blue domed" cyst
Fibrocystic change 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 macroglobulinemia (M protein = IgM)
- Primary amyloidosis
68
Mucin filled cell with peripheral nucleus
Signet ring (diffuse gastric carcinoma) w/ linitis plastica
69
Narrowing of bowel lumen on barium XR
"String sign" Crohn's disease
70
Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis
Wegener's GPA (c-ANCA positive) and Goodpasture's (anti-basement membrane antibodies)
71
Needle-shaped, negatively birefringent crystals
Gout (monosodium urate crystals)
72
Nodular hyaline deposits in glomeruli
Kimmelsteil Wilson nodules (diabetic nephropathy)
73
Novobiocin response
Sensitive: S. epidermidis, resistant: S. saprophyticus
74
Nutmeg 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: S. pneumo; resistant: Viridans
77
Periosteum raised from bone, creating triangular area
Codman's triangle on XR (osteosarcoma, Ewing's sarcoma, pyogenic osteomyelitis)
78
Podocyte fusion or effacement on electron microscopy
Minimal change disease (child with nephrotic syndrome) or FSGS
79
Polished ivory like appearance of bone at cartilage erosion
Eburnation (osteoarthritis resulting in bony sclerosis)
80
Protein aggregates in neurons from hyperphosphorylation of protein tau
Neurofibrillary tangles (Alzheimer's) and Pick's bodies (Pick's disease)
81
Psammoma bodies
Meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of 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 XR
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 XR
Epiglottitis (H. influenzae)
98
Thyroid-like appearance of kidney
Chronic bacterial pyelonephritis
99
Tram track appearance of capillary loops of glomerular BM on light microscopy
Membranoproliferative glomerulonephritis
100
Triglyceride accumulation in liver cell vacuoles
Fatty liver disease (alcoholic or metabolic syndrome)
101
Waxy casts with very low urine flow
Chronic end stage renal disease
102
WBC casts in urine
Acute pyelo
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 (ex: due to subarachnoid hemorrhage)
