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lab/diagnostic find
lab diagnostic findings FA 2017
| Question | Answer |
|---|---|
| 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
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