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Rapid Review 2
Classic Labs/Findings
| Question | Answer |
|---|---|
| AntiCentromere Antibodies | Scleroderma (CREST) |
| AntiDesmoglein(Epithelial) antibodies | Pemphigus Vulgaris (blistering) |
| Anti-Glomerular Basement Membrane antibodies | Goodpasture's syndrome (glomerulonephritis and hemoptysis) |
| AntiHistone antibodies | Drug-induced SLE (Hydralazine, INH, Phenytoin, Procainamide) |
| Anti-IgG antibodies | Rheumatoid arthritis (systemic inflamation, joint pannus, boutonniere deformity) |
| AntiMitochondrial antibodies (AMA's) | 1° biliary cirrhosis(female, cholestasis, portal HTN) |
| Anti-Neutrophil Cytoplasmic antibodies (ANCA'S) | Vasculitis(C-ANCA:granulomatosis w/polyangitis[Wegener's], P-ANCA: microscopic polyangitis, Churg-Strauss syndrome) |
| AntiNuclear antibodies(ANA's:Anti-Smith and anti-dsDNA) | SLE(Type III hypersensitivity) |
| AntiPlatelet antibodies | Idiopathic Thrombocytopenic Purpura (ITP) |
| Anti-Topoisomerase antibodies | Diffuse Systemic Scleroderma |
| Anti-Transglutaminase/Anti-Gliadin/Anti-Endomysial antibodies | Celiac Disease (diarrhea, distention, weight loss) |
| "Apple core" lesion on abdominal x-ray | Colorectal cancer (usually left sided) |
| Azurophilic peroxidase-positive granular inclusions in granulocytes and myeloblasts | Auer Rods (Acute Myelogenous Leukemia AML especially promyelocytic [M3] type |
| Bacitracin response | Sensitive:Strep pyogenes(Group A); Resistant:Strep agalactiae(Group B) |
| "Bamboo spine" on x-ray | Ankylosing spondylitis (Chronic inflammatory arthritis:HLA-B27) |
| Basophilic nuclear remnants in RBC's | Howell-Jolly bodies(due to splenectomy or nonfunctional spleen) |
| Basophilic stippling of RBC's | Lead poisoning or Sideroblastic anemia |
| Bloody tap on LP | Subarachnoid Hemorrhage |
| "Boot shaped" heart on x-ray | Tetralogy of Fallot, RVH |
| Branching gram + rods with sulfur granules | Actinomyces israelii |
| Bronchogenic apical lung tumor on imaging | Pancoast tumor (can compress sympathetic cervical ganglion and cause Horner syndrome) |
| "Brown" tumor on bone | HyperParathyroidism or Osteitis Fibrosa Cystica (deposited hemosiderin from hemorrhage gives brown color) |
| Cardiomegaly w/ apical atrophy | Chagas disease (Trypanosoma cruzi) |
| Cellular crescents in Bowman's capsule | Rapidly progressive crescentic glomerulonephritis |
| "Chocolate cyst" in ovary | Endometriosis (frequently involves both ovaries) |
| Circular grouping of dark tumor cells surrounding pale neurofibrils | Homer-Wright rosettes (Neuroblastoma, Medulloblastoma, Retinoblastoma) |
| Colonies of mucoid Pseudomonas in lungs | Cystic Fibrosis (AR mutation of CFTR resulting in fat-soluble vitamin deficiency and mucous plugs) |
| Decreased α-feto protein in amniotic fluid/maternal serum | Down's syndrome or other chromosomal abnormality |
| Degeneration of dorsal column nerves | Tabes Dorsalis(3° Syphilis), Subacute Combined Degeneration(Dorsal columns and Lateral CorticoSpinal tracts affected) |
| Depigmentation of neurons in Substantia Nigra | Parkinsons disease (basal ganglia disorder:rigidity, resting tremor, bradykinesia) |
| Desquamated epithelial casts in sputum | Curschmann's spirals(Bronchial Asthma; can result in whorled mucous plugs) |
| Disarrayed granulosa cells in eosinophillic fluid | Call-Exner bodies(Granulosa Theca cell tumor of the ovary) |
| Dysplastic squamous cervical cells w/ nuclear arrangement and hyPERchromasia | Koilocytes(HPV:predisposes to cervical cancer) |
| Enlarged cells w/ intranuclear inclusion bodies | "Owl's Eye" appearance of CMV |
| Enlarged thyroid cells w/ Ground Glass nuclei | "Orphan Annie eyes" nuclei (Papillary Carcinoma of the Thyroid) |
| Eosinophilic cytoplasmic inclusion in liver cell | Mallory bodies(alcoholic liver disease) |
| Eosinophilic cytoplasmic inclusion in nerve cell | Lewy body (Parkinsons disease) |
| Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells | Negri bodies if rabies (Lyssavirus) |
| Extracellular amyloid deposition in gray matter of brain | Senile Plaques (Alzeimer disease) |
| Giant B Cells with bilobed nuclei w/ prominent inclusions ("owl's eye") | Reed Sternberg cells(Hodgekins Lymphoma) |
| Glomerulus-like structure surrounding vessel in germ cells | Schiller-Duval bodies (Yolk Sac tumor) |
| "Hair on End" Crew Cut appearance on x-ray | β-Thallasemia, Sickle Cell anemia (Marrow Expansion) |
| hCG elevated | Choriocarcinoma, hydatidiform mole (occurs w/ and w/out embryo) |
| Heart nodules(granulomatous) | Aschoff bodies(Rheumatic Fever) |
| Heterophile antibodies | Infectious Mononucleosis(EBV) |
| Hexagonal, double-pointed, needle-like crystals in bronchial secretions | Bronchial asthma(Charcot Leyden crystals: eosinophilic granules) |
| High level of D-Dimers | DVT, Pulmonary Embolism, DIC |
| Hilar Lymphadenopathy, Peripheral granulomatous lesion in middle/lower lung lobes(can calcify) | Ghon focus(1° TB: Mycobacterium bacilli) |
| "Honeycomb lung" on x-ray or CT | Interstitial pulmonary fibrosis |
| Hypercoagulability (leading to migrating DVT's and Vasculitis) | Trousseau's syndrome(AdenoCA of Pancreas or Lung) |
| Hypersegmented neutrophils | Megaloblastic anemia(B12 deficiency:neurologic symptoms; Folate deficiency:NO neurologic symptoms) |
| HyPERtension, HyPOkalemia, Metabolic ALKalosis | Conn's syndrome |
| HyPOchromic , MIcrocytic anemia | Iron def anemia, Lead poisoning, Thalassemia (fetal hb sometimes present) |
| Increased α-feto protein in amniotic fluid/maternal serum | Dating error, Anencephaly, Spina Bifida(Neural tube defects) |
| Increased Uric Acid levels | Gout, Lesch Nyhan syndrome, Tumor Lysis Syndrome, Loop and Thiazide Diuretics |
| Intranuclear Eosinophilic Droplet-like bodies | Cowdry Type A bodies (HSV or CMV) |
| Iron Containing nodules Alveolar Septum | Ferruginous bodies (Asbestos:↑ chance of Mesothelioma) |
| Keratin Pearls on Skin Biopsy | Squamous Cell Carcinoma |
| Large Lysosomal vesicles in phagocytese, immunodeficiency | Chediak-Higashi disease (congenital failure of phagolysosome formation) |
| "Lead Pipe" appearance on colon on barium enema xray | Ulcerative Colitis(Loss of Haustra) |
| Linear appearance of IgG deposition on Glomerular Basement Membrane | Goodpasture's Syndrome |
| Low serum Ceruloplasmin | Wilson's Disease (Hepatolenticular degeneration) |
| "Lumpy Bumpy" appearance of glomeruli on Immunofluorescence | PostStreptococcal Glomerulonephritis (immune complex deposition of IgG and C3b) |
| Lytic "Hole punched" bone lesions on x-ray | Multiple Myeloma |
| Mammary Gland "Blue Domed" cyst | Fibrocystic change of breast |
| 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 |
| Mucin-filled cell w/ peripheral nucleus | Signet Ring (Gastric Carcinoma) |
| Narrowing of Bowel Lumen on barium xray | "String sign" (Crohn's disease) |
| Necrotizing vasculitis (lungs) and Necrotizing glomerulonephritis | Granulomatosis w/ Polyangitis(Wegener's:C-ANCA)and Goodpastures syndrome(anti-basement membrane antibodies) |
| Needle shaped, negatively birefringent crystals | Gout(monosodium urate crystals) |
| Nodular hyaline deposits in glomeruli | Kimmelstein Wilson nodules (Diabetic nephropathy) |
| Novobiocin response | Sensitive: Staph epidermidis; Resistant: Staph saprophyticus |
| "Nutmeg" appearance of the liver | Chronic passive congestion of liver due to Right heart failure |
| "Onion skin" preiosteal reaction | Ewing's Sarcoma(malignant round cell tumor) |
| Optochin response | Sensitive:Strep.pneumo; Resistant:Viridans streptococcus |
| Periosteum raised from bone; creating triangular areas | Codman's triangle on xray(Osteosarcoma, Ewing's Sarcoma, Pyogenic Osteomyelitis) |
| Podocyte fusion or "effacement" on electron microscopy | Minimal change disease(child w/ nephrotic syndrome) |
| Polished "ivory like appearance" of bone at cartilage erosion | Eburnation(osteoarthritis resulting in bony sclerosis) |
| Protein aggregates in neurons from hyperphosphorylation of protein tau | Neurofibrillary tangles(Alzeimers disease) and Pick Bodies (Pick's disease) |
| Psommama bodies | Meningiomas, Papillary Thyroid Carcinoma, Mesothelioma, Papillary Serous CA of the Endometrium and Ovary |
| Pseudopalisading tumor cells on brain biopsy | Glioblastoma Multiforme |
| RBC Casts in urine | Acute Glomerulonephritis |
| Rectangular, crystal like, Cytoplasmic inclusions in Leydig Cells | Reinke Crystals(Leydig Cell Tumor) |
| Renal Epithelial Casts in Urine | Acute toxic/viral nephrosis |
| Rhomboid crystals, positively birefringent | Pseudogout(Cacium pyrophosphate dihydrate crystals) |
| Rib notching | Coarctation of the Aorta |
| Ring Enhancing brain lesions in AIDS | Toxoplasma gondii, CNS Lymphoma |
| Sheets of medium sized lymphoid cells with scattered pale, tingible body-laden macrophages("starry sky" histology) | Burkitt's Lymphoma(t[14:18],c-myc activation, assoc. w/ EBV; black sky made up of malignant cells) |
| Silver-staining spherical aggregation of tau proteins in neurons | Pick bodies(Pick's Disease: progressive dementia, changes in personality) |
| "Soap bubble" in femur or tibia on xray | Giant Cell tumor of bone(generally benign) |
| "Spikes" on basement membrane, "dome" like epithelial deposits | Membranous Glomerulonephritis(may progress to nephrotic syndrome) |
| Stacks of RBC's | Rouleaux formation(high ESR, Multiple Myeloma) |
| Stippled vaginal epithelial cells | "Clue Cells" (Gardnerella Vaginalis) |
| "Tennis Raquet" shaped cytoplasmic organelles(EM)in Langerhans Cells | Birbeck granules(Langerhans Cell Histiocytosis)or Histiocytosis X: Eosinophillic Granuloma) |
| Thrombi made of red/white layers | Lines of Zahn(arterial thrombus, layers of platelets/RBCs) |
| "Thumb Sign" in lateral Xray | Epiglotitis(Haemophilus influenzae) |
| Thyroid-like appearance of Kidney | Chronic bacterial pyelonephritis |
| Tram-track appearance of capillary loops of glomerular basement membranes on light microscopy | Membranoproliferative glomerulonephritis |
| Triglyceride accumulation in liver cell vacuoles | Fatty Liver disease(Alcoholic or Metabolic syndrome) |
| "Waxy" casts w/ very low urine flow | Chronic end-stage renal disease |
| WBC casts in urine | Acute Pyelonephritis |
| WBC's that look smudged | CLL(almost always B Cell) |
| "Wire Loop" glomerular capillary appearance on light microscopy | Lupus nephropathy |
| Yellowish CSF | Xanthochromia (ex: due to subarachnoid hemorrhage) |
Created by:
sdona2
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