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FA10 Labs/Findings

FA 2010 Classic Labs & Findings

Anticentromere antibodies Scleroderma (CREST)
Antidesmoglein (epithelial) antibodies Pemphigus vulgaris (blistering)
Anti-glomerular basement membrane antibodies Goodpasture's Syndrome (glomerulonephritis and lung hemorrhage)
Antihistone antibodies Drug-induced SLE
Anti-IgG antibodies Rheumatoid arthritis (systemic inflammation, joint pannus, boutonniere deformity)
Antimitichondrial antibodies (AMAs) Primary biliary cirrhosis (female, cholestasis, portal hypertension)
Antineutrophil cytoplasmic antibodies (ANCAs) Vasculitis (Wegener's, microscopic polyangiitis, glomerulonephritis)
Antinuclear antibodies (ANAs: anti-Smith and anti-dsDNA) SLE (type II hypersensitivity)
Antiplatelet antibodies Idiopathic thrombocytopenic purpura (ITP) (bleeding diathesis)
Anti-topoisomerase antibodies Diffuse systemic scleroderma
Anti-transglutaminase/ antigliadin antibodies Celiac disease (diarrhea, distension, weight loss)
Azurophilic granular needles in leukemic blasts Auer rods (AML: especially the promyelotic type)
"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 sideroblastic anemia
Bloody tap on LP Subarachnoid hemorrhage
"Boot-shaped" heart on x-ray Tetralogy of Fallot, RVH
Branching gram-positive rods with sulfur granules Actinomyces israelii
Bronchogenic apical lung tumor Pancoast's tumor (can compress sympathetic ganglion and cause Horner's syndrome)
"Brown" tumor of bone Hemorrhage (hemosiderin) causes brown color of osteolytic cysts. Due to: 1. Hyperparathyroidism 2. Osteitis fibrosa cystica (von Recklinghausen's disease of bone)
Cardiomegaly with apical atrophy Chaga's disease (Trypanosoma cruzi)
Cellular crescents in Bowman's 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, meduloblastoma, retinoblastoma)
Colonies of mucoid Pseudonomas in lungs Cystic fibrosis (CFTR mutation in Caucasians resulting in fat-soluble vitamin deficiency and mucous plugs)
Degeneration of dorsal column nerves Tabes dorsalis (tertiary syphilis)
Depigmentation of neurons in substantia nigra Parkinson's 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 eosinophilic fluid Call-Exner bodies (granulosa-theca cell tumor of ovary)
Dysplastic squamous cervical cells with nuclear enlargement and hyperchomasia Koilocytes (HPV: predisposes to cervical cancer)
Enlarged cells with intranuclear inclusion bodies "Owl's-eye" appearance of CMV
Enlarged thyroid cells with ground-glass nuclei "Orphan Annie" eye nuclei (papillary carcinoma of the thyroid)
Eosinophilic cytoplasmic inclusion in liver cells Mallory bodies (alcoholic liver disease)
Eosinophilic cytoplasmic inclusion in nerve cells Lewy body (Parkinson's disease)
Eosinophilic globule in liver Councilman body (toxic or viral hepatitis, often yellow fever)
Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cells Rabies virus (Lyssavirus)
Extracellular amyloid deposition in gray matter of brain Senile plaques (Alzheimer's disease)
Giant B cells with bilobed nuclei with prominent inclusions ("owl's eye") Reed-Sternberg cells (Hodgkin's lymphoma)
Glomerulus-like structure surrounding vessel in germ cells Schiller-Duval bodies (yolk sac tumor)
"Hair-on-end" (crew-cut) appearance on x-ray beta-thalassemia, sickle cell anemia (extramedullary hematopoiesis)
hCG elevated Choriocarcinoma, hydatidiform mole (occurs with or without embryo)
Heart nodules (inflammatory) 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
"Honeycomb lung" on x-ray Interstitial fibrosis
Hypersegmented neutrophils Megaloblastic anemia (B12, folate deficiency)
Hypochomic, microcytic anemia Iron deficiency anemia, lead poisoning, thalassemia (HbF sometimes present)
Increased alpha-fetoprotein in amniotic fluid/ maternal serum Anencephaly, spina bifida (neural tube defects)
Increased uric acid levels Gout, Lesch-Nyhan syndrome, myeloproliferative disorders, loop and thiazide diuretics
Intranuclear eosinophilic droplet-like bodies Cowdry type A bodies (HSV or yellow fever)
Iron-containing nodules in alveolar septum Ferruginous bodies (asbestosis: increased chance of mesothelioma)
Large lysosomal vesicles in phagocytes, immunocompromised Chediak-Higashi disease (failure of phagolysosome formation)
Low serum ceruloplasmin Wilson's disease (hepatolenticular degeneration)
"Lumpy-bumpy" appearance of glomeruli on immunofluorescence Poststreptococcal glomerulonephritis
Lytic ("hole-punched") bone lesions on x-ray Multiple myeloma
Mammary gland ("blue-domed") cyst Fibrocystic change of the breast
Monoclonal antibody spike 1. Multiple myeloma (called the M protein; usally IgG or IgA) 2. Monoclonal gammopathy of undetermined significance (MGUS) 3. Waldenstrom's (M protein = IgM) macroglobulinemia
Monoclonal globulin protein in blood/urine Bence Jones proteins (multiple myeloma [kappa or lambda Ig light chains in urine]), Waldenstrom's (IgM)
Mucin-filled cell with peripheral nucleus Signet cell (gastric carcinoma)
Narrowing of bowel lumen on barium radiograph "String sign" (Crohn's disease)
Needle-shaped, negatively birefringent crystals Gout (hyperuricemia)
Nodular hyaline deposits in glomeruli Kimmelstiel-Wilson nodules (diabetic nephropathy)
"Nutmeg" appearance of liver Chronic passive congestion of liver due to right heart failure
"Onion-skin" periosteal reaction Ewing's sarcoma (malignant round-cell tumor)
Periosteum raised from bone, creating triangular area Codman's triangle on x-ray (osteosarcoma, Ewing's sarcoma, pyogenic osteomyelitis)
Podocyte fusion on EM Minimal change disease (child with nephrotic syndrome)
Polished, "ivory-like" appearance of bone at cartilage erosion Eburnation (osteoarthritis resulting in body sclerosis)
Protein aggregates in neurons from hyperphosphorylation of protein tau Neurofibrillary tangles (Alzheimer's disease and CJD)
Pseudopalisade tumor cell arrangement Glioblastoma multiforme
RBC casts in urine Acute glomerulonephritis
Rectangular, crystal-like inclusions in Leydig cells Reinke crystals (Leydig cell tumor)
Renal epithelial casts in urine Acute toxic/ viral nephrosis
Rhomboid crystals, positively birefringent Pseudogout (calcium pyrophosphate dihydrate)
Rib notching Coarctation of the aorta
Sheets of medium-sized lymphoid cells ("starry sky" appearance on histology) Burkitt's lymphoma (t[8:14] c-myc activation, associated with EBV)
Silver-staining spherical aggregation of tau proteins in neurons Pick bodies (Pick's disease: progressive dementia, similar to Alzheimer's)
Small granulomatous lesions in lungs (can calcify) Ghon focus (primary TB: Mycobacterium bacilli)
Small, round RBC inclusions Heinz bodies (G6PD deficiency, alpha-thalassemia, chronic liver disease)
"Soap bubble" on x-ray Giant cell tumor of bone (generally benign)
"Spikes" on basement membrane, "dome-like" endothelial deposits Membranous Glomerulonephritis (may progress to nephrotic syndrome)
Stacks of red blood cells Rouleaux formation (high ESR: multiple myeloma)
Stippled vaginal epithelial cells "Clue cells" (Gardnerella vaginalis)
"Tennis-racket"-shaped cytoplasmic organelles (EM) in Langerhans cells Birbeck granules (histiocytosis X: eosinophilic granuloma)
Thrombi made of white/ red layers Lines of Zahn (arterial thrombus, layers of platelets/RBCs)
"Thumb sign" on lateral x-ray Epiglottitis (Haemophilus influenzae)
Thyroid-like appearance of kidney Chronic bacterial pyelonephritis
"Tram-track" appearance on LM Membranoproliferative glomerulonephritis
Triglyceride accumulation in liver cell vacuoles Fatty liver disease (alcoholic or metabolic syndrome)
WBCs that looked "smudged" CLL (almost always B cells; affects the elderly)
"Wire loop" glomerular appearance on LM Lupus nephropathy
Yellow CSF Xanthochromia (subarachnoid hemorrhage)
Created by: megankirch