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lab/diagnostic find

lab diagnostic findings FA 2017

QuestionAnswer
AFP in amniotic fluid/maternal serum dating error, anencephaly, spina bifida (neural tube defects)
anticentromere antibodies scleroderma (CREST)
anti-desmoglein (anti-desmosome) antibodies Pemphigus vulgaris (Blistering)
Anti-glomerular basement membrane antibodies Goodpasture syndrome (glomerulonephritis and hemoptysis)
antihistone antibodies Drug-induced SLE (eg, hydralazine, isoniazid, phenytoin, procainamide)
Anti-IgG antibodies Rheumatoid arthritis (systemic inflammation, joint panes, boutonniere deformity)
Antimitochondrial antibodies (AMAs) 1 degree biliary cirrhosis (female, cholestasis, portal hypertension)
Antineutrophil cytoplasmic antibodies (ANCAs) microscopic polyangiitis and eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome) (MPO-ANCA/p-ANCA); granulomatosis with polyangiitis (Wegener;PR3-ANCA/c-ANCA)
Antinuclear antibodies (ANAs: anti-Smith and anti-dsDNA) SLE (type III Hypersensitivity)
Antiplatelet antibodies Diffuse systemic scleroderma
Anti-topoisomerase antibodies Diffuse systemic scleroderma
Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies Celiac disease (diarrhea, weight loss)
"Apple core" lesion on barium enema x-ray Colorectal cancer (usually left-sided)
Atypical lymphocytes EBV
Azurophilic peroxidase + granular inclusions in granulocytes and myeloblasts Auer rods (AML, especially the promyelocytic [m3] type)
Bacitracin response sensitive: S progenies (group A) resistant: S agalactiae (group B)
"Bamboo spine" on x-ray Ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27)
Basophilic nuclear remnants in RBCs Howell-Jolly bodies (due to splenectomy or nonfunctional spleen)
Basophilic stippling of RBCs lead poisoning or siderblastic anemia
Bloody or yellow tap on lumbar puncture Subarachnoid hemorrhage
"Boot-shaped" heart on x-ray Tetralogy of Fallot (due to RVH)
Branching gram + rods with sulfur granules Actinomyces israelii
Bronchogenic apical lung tumor on imaging Pancoast tumor (can compress cervical sympathetic chain and cause Horner syndrome)
"Brown" tumor of bone Hyperparathyroidism or osteitis fibrous cystic (deposited hemosiderin from hemorrhage gives brown color)
Cardiomegaly with apical atrophy Chagas diseases (Trypanosoma Cruzi)
Cellular crescents in bowman capsule Rapidly progressive crescentic glomerulonephritis
"Chocolate cyst" of ovary endometriosis (frequently involves both ovaries)
Circular grouping of dark tumor cells surrounding pale neurofibrils Homer-wright rosettes (neuroblastoma, medulloblastoma)
colonies of mucoid Pseudomonas in lungs Cystic fibrosis (autosomal recessive mutation in CFTR gene --> fat-soluble vitamin deficiency and mucous plugs)
AFP in amniotic fluid/ maternal serum Down syndrome or other chromosomal abnormalities
degeneration of dorsal column fibers tabes dorsalis (3 degree syphilis) subacute combined degeneration (dorsal columns, lateral corticospinal, spinocerebellar tracts affected)
"Delta wave" on EKG, short PR interval, supra ventricular tachycardia Wolff-Parkinson - White syndrome (Bundle of Kent bypasses AV node)
Depigmentation of neurons in substantial nigra Parkinson disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia)
Desquamated epithelium casts in sputum Curschmann spirals (bronchial asthma; can result in whorled mucous plugs)
Disarrayed granulose cells arranged around collections of eosinophilic fluid Call-Exner bodies (granulose cell tumor of the ovary)
dysplastic squamous cervical cells with "raisinoid" nuclei and hyperchromasia Koilocytes (HPV: predisposes to cervical cancer)
electrical alternans (alternating amplitude on EKG) pericardial tamponade
enlarged cells with intranuclear inclusion bodies "owl eye" appearance of CMV
enlarged thyroid cells with ground-glass nuclei with central clearing "orphan Annie" eyes nuclei (papillary carcinoma of the thyroid)
Eosinophilic cytoplasmic inclusion in liver cell mallory body (alcoholic liver disease)
Eosinophilic cytoplasmic incursion in neuron Lewy body (Parkinson disease and levy body dementia)
Eosinophilic globule in liver councilman body (viral hepatitis, yellow fever) represents hepatocyte undergoing apoptosis
Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar neurons negri bodies of rabies
Extracellular amyloid deposition in gray matter of brain senile plaques (alzheimer disease)
Giant B cells with bilobed nuclei with prominent inclusions ("owl's eye") Reed-Sternberg cells (Hodgkin lymphoma)
Glomerulus-like structure surrounding vessel in germ cells schiller Duval bodies (yolk sak tumor)
"Hair on end" ("crew-cut") appearance on x-ray B- Thalassemia, sickle cell disease (marrow expansion)
HcG elevated Choriocarcinoma, hydatidiform mole (occurs with and without embryo, and multiple pregnancy)
Heart nodules (granulomatous) Aschloff 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, PE, DIC
Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify) Ghon complex (1 degree TB: Mycobacterium bacilli)
"honeycomb lung" on x-ray or CT interstitial pulmonary fibrosis
hypercoagulabilitiy (leading to migrating DVTs and vasculitis) Trousseau syndrome (adenocarcinoma of pancreas or lung)
hyperhsegmented neutrophils Megaloblastic anemia (B12 deficiency: neurologic symptoms; folate deficiency: no neurologic symptoms)
hypertension, hypokalemia, metabolic alkalosis 1 degree hyperaldosteronism (Conn syndrome)
Hypochromic, microcytic anemia Iron deficiency anemia, lead poisoning, thalassemia (fetal hemoglobin sometimes present)
Intranuclear eosinophilic droplet-like bodies Cowdry type A bodies (HSV or VZV)
iron-containing nodules in alveolar septum Ferruginous bodies (asbestosis: ^ chance of mesothelioma)
keratin pearls on a skin biopsy Squamous cell carcinoma
large granules in phagocytes, immunodeficiency Chediak - Higashi disease (congenital failure of phagolysosome formation)
"lead pipe" appearance of colon on abdominal imaging Ulcerative colitis (loss of haustra)
linear appearance of IgG deposition on glomerular and alveolar basement membranes Goodpasture syndrome
low serum ceruloplasmin wilson disease (hepatonticular degeneration)
lumpy bumpy appearance of glomeruli on immunofluorescence post streptococcal glomeruloneprhritis (due to deposition of IgG, IgM, and C3)
lytic (punched out) bone lesions on X-ray Multiple Myeloma
mammary gland (blue domed) cyst fibrocystic change of the breast
monoclonal antibody spike 1. multiple myeloma (usually IgG or IgA) 2. monoclonal gammapathy of undetermined significance (MGUS consequence of aging) 3. Waldenstrom (M protein-IgM) macroglobulinemia 4. Primary amyloidosis
mucin filled cell with peripheral nucleus signet ring (gastric carcinoma )
narrowing of bowel lumen on barium x-ray string sign (Crohn disease)
necrotising vasculitis (lungs) and necrotising glomerulonephritis granulomatosis of polyangiitis (Wegener; PR3-ANCA/c-ANCA) and good pasture syndrome (anti-basement membrane antibodies)
needle shaped , negative birefringent crystals gout (monosodium urate crystals)
nodular hyaline deposits in glomeruli kimmelstier-wilson nodules (diabetic nephropathy)
novobiocin response sensitive: S epidermidis, resistant : S saprophyticus
nutmeg appearance of liver chronic passive congestion of liver due to right heart failure or Budd-Chiari syndrome
onion skin periosteal reaction ewing sarcoma (malignant small blue cells)
optochin response sensitive: S pneumonia , resistant: viridian's streptococci (S mutants, S sanguis)
podocyte fusion or effacement on electron microscopy minimal change disease (child with nephrotic syndrome)
polished, ivory like appearance of bone at cartilage erosion eburnation (osteoarthritis resulting in bone sclerosis)
protein aggregates in neutrons from hyperphosphorylation of tau protein neurofibrillary tangles (alzheimers disease) and pick bodies (pick disease)
psammoma bodies meningioma, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of endometrium and ovary
pseudopalisading tutor cells on brain biopsy glioblastoma multiforme
raised periosteum (creating a "conman triangle") aggressive bone lesion (ex: osteosarcoma, ewing sarcoma, osteomyelitis)
RBC casts in urine glomerulonephritis
rectangular, crystal like, cytoplasmic inclusions in Leydig cells Reinke crystals (Leydig cell tumor)
Recurrent infections, eczema, thrombocytopenia wiskott-aldrich syndrome
renal epithelial casts in urine intrinsic renal failure (ex: ischemia or toxic injury)
rhomboid crystals, + birefringent pseudo gout (calcium pyrophosphate dihydrate crystals)
Rib notching (inferior surface, on Xray) coarctation of the aorta
ring enhancing brain lesion on CT/MRI in AIDS toxoplasma gondii, CNS lymphoma
sheets of medium sized lymphoid cells with scattered pale, tangible body-laden macrophages (starry sky) histology Burkitt lymphoma t(8:14), c myc activation, a
silver staining spherical aggregation of tau proteins in neurons pick bodies (pick disease: progressive dementia , chances in personality)
soap bubble in femur or tibia on X-ray giant cell tutor of bone (generally benign)
spikes on basement membrane, dome like sub epithelial deposits membranous nephropathy (nephrotic syndrome)
stacks of RBC rouleax formation (high ESR, multiple myeloma)
steeple sign on frontal CXR croup (parainfluenza virus)
stippled vagina epithelial cells clue cells (gardnerella vaginalis)
streptococcus bovis bacteremia colon cancer
tennis racket shaped cytoplasmic organelles (EM) in langerhans cells birbeck granules (langerhans cell histiocytes)
thousands of polyps on the colon familial adenomatous polyposis (autosomal dominant, mutation of APC gene)
thrombi made of white/red layers lines of zahn ( arterial thrombus, lakers of platelets/ RBCs)
thumb sign on lateral neck of xray epiglottitis (haemophilus influenza)
thyroid like appearance on kidney chronic pyelonephritis (usually due to recurrent infections)
tram track appearance of capillary loops of glomerular basement membranes on light microscopy membranoproliferazive glomerulonephritis
triglyceride accumulation in liver cells vacuoles fatty liver disease (alcoholics or metabolic syndrome)
increased uric acid levels 1.gout 2.lesch-nyhan syndrome, 3.tumor lysis syndrome, 4.loop 5. thiazide diuretics
waxy casts with very low urine flow chronic end stage renal disease
WBC casts in urine acute pyelonephritis
WBCs that look "smudged" CLL (almost always B cells)
Wire loop glomerular capillary appearance on light microscopy Diffuse proliferative glomerulonephritis (usually seen with lupus)
Yellowish CSF xanthochromia (ex: due to subarachnoid haemorrhages)
Created by: larissasz