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Step 1: Lab Findings

QuestionAnswer
Anticentromere antibodies Scleroderma (CREST)
Antidesmoglein (epithelial) antibodies Pemphigus vulgaris (blistering)
Anti-GBM antibodies Goodpasture's (glomerulonephritis and hemoptysis)
Anti-IgG antibodies Rheumatoid arthritis (systemic inflammation, joint pannus, boutonniere deformity)
Antihistone antibodies Drug induced SLE (hydralazine, isoniazid, phenytoin, procainamide)
Antimitochondrial antibodies (AMA) Primary biliary cirrhosis (Female, cholestasis, portal HTN)
Antineutrophil cytoplasmic antibodies (ANCAs) Vasculitis (c-ANCA: wegener's; p-ANCA: microscopic polyangiitis, Churg-Strauss syndrome)
Antinuclear antibodies (ANAs: anti-smith, anti-dsDNA SLE (type III hypersensitivity)
Antiplatelet antibodies ITP
Anti-topoisomerase antibodies Diffuse systemic scleroderma
"Apple core" lesion on abdominal X ray Colorectal cancer (usually left sided)
Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies Celiac disease (diarrhea, distention, weight loss)
Azurophilic granular needles in leukemic blasts Auer rods, AML especially M3 type
Bacitracin response Sensitive: Streptococcus pyogenes (group A); resistant: Streptococcus agalactiae (group B)
Bamboo spine on X Ray Ankylosing spondylitis (HLA-B27)
Basophilic nuclear remnants in RBCs Howell-Jolly bodies (splenectomy, nonfx 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 + rods with sulfur granules Actinomyces israelii
Bronchogenic apical lung tumor Pancoast tumor - can compress sympathetic ganglion and cause Horner's syndrome
"Brown" tumor of bone Hemorrhagic (hemosiderin) causes brown color of osteolytic cysts Due to: hyperparathyroidism, osteitis fibrosa cystica
Cardiomegaly with apical atrophy Chagas disease (T. Cruzi)
Cellular crescents in Bowman's capsule Rapidly progressive crescenteric glomerulonephritis
"Chocolate cyst" of 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 CF (AR mutation to CFTR resulting in fat-soluble vitamin deficiency and mucous plugs)
Decreased a-fetoprotein in amniotic fluid/maternal serum Down syndrome or other chromosomal abnormality
Degeneration of dorsal column nerves Tabes dorsalis (tertiary syphilis)
Depigmentatin of neurons in the substantia nigra Parkinson's disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia)
Desquamated epithelium 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 the ovary)
Dysplastic squamous cervical cells w/nuclear enlargement and hyperchromasia Koilocytes (HPV - predisposes to cervical cancer)
Enlarged cells with intranuclear inclusion bodies "Owls 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 cell Mallory bodies (alcoholic liver disease)
Eosinophilic cytoplasmic inclusion in nerve cell Lewy body (Parkinsons 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
Giant B cells with bilobed nuclei with prominent inclusions "owls eye" Reed Sternberg cells (Hodgkins lymphoma)
Extracellular amyloid deposition in gray matter in the brain Senile plaques (Alzheimer's disease)
Glomerulus-like structure surrounding vessel in germ cells Schiller-Duval bodies (yolk sac tumor)
"Hair-on-end" crew cut appearance on x ray B-thalassemia, sickle cell anemia (marrow expansion)
hCG elevated Choriocarcinoma, hydatidiform mole (occurs with and without embryo)
Heart nodules 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 levels of D - dimer DVT, PE, DIC
Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify) Ghon complex (primary TB, Mycobacterium bacilli)
"Honeycomb" lung on xray Interstitial fibrosis
Hypersegmented neutrophils Megaloblastic anemia (B12 deficiency = neurologic symptoms, folate deficiency = no neurologic symptoms)
Hypochromic microcytic anemia Iron def anemia, lead poisoning, thalassemia (HbF sometimes present)
Increased alpha-fetoprotein in amniotic fluid 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 in alveolar septum Ferruginous bodies (asbestosis: increased chance of mesothelioma)
Large lysosomal vesicles in phagocytes, immunodeficiency Chediak-Higashi disease (congenital failure of phagolysosome formation)
"Lead pipe" appearance of colon on xray ulcerative colitis (loss of haustra)
LINEAR appearance of glomeruli on immunofluorescence Goodpasture's Syndrome
Low serum ceruloplasmin Wilson's disease (hepatolenticular degeneration)
"Lumpy bumpy" appearance of glomeruli on immunofluorescence Post-streptococcal 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 the breast
Monoclonal antibody spike 1. Multiple myeloma (called the M protein, usually IgG or IgA) 2. Monoclonal gammopathy of undetermined significance (MGUS- normal consequence of aging 3. Waldenstrom's (M protein = IgM) 4. Primary amyloidosis
Monoclonal globulin protien in blood/urine Bence Jones proteins (multiple myeloma), Waldenstrom's macroglobulinemia (IgM)
Mucin-filled cell with peripheral nucleus Signet ring (gastric carcinoma)
Narrowing of bowel lumen on barium graph "String sign" Crohns disease
Needle-shaped, negatively bifringent crystals Gout (monosodium urate crystals)
Nodular hyaline deposits in glomeruli Kimmelstiel-Wilson nodules
Novobiocin response Sensitive: staph epidermis Resistant: staph saprophyticus
"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)
Optochin response Sensitive: Strep pneumoniae Resistant: Strep viridans
Periosteum raised from bone, creating a triangular area Codman's triange on x-ray (osteosarcoma, Ewing sarcoma, pyogenic osteomyelitis)
Podocyte fusion on EM Minimal change disaese (child w/nephrotic syndrome)
Polished "ivory like" appearance of bone at cartilage erosion Eburnation (OA resulting in bony sclerosis)
Pseudopalasading tumor cells on brain biopsy Glioblastoma multiforme
RBC casts in urine Acute glomerulonephritis
Protein aggregates in neurons from hyperphosphorylation of protein tau Neurofibrillary tangles (Alzheimers disease and CJD)
Renal epithelial casts in urine Acute toxic/viral nephrosis
Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells Reinke crystals (Leydig cell tumor)
Rhomboid crystals, positively bifringent Pseudogout (calcium pyrophosphate dihydrate)
Rib notching Coarctation of aorta
Ring enhancing lesions in AIDS pts Toxoplasma gondii
Sheets of medium sized lymphoid cells "starry sky appearance" Burkitts lymphoma (t8; 14) c-myc activation, associated with EBV, "black sky" made up of malignant cells
"Soap bubble" in femur or tibia Giant cell tumor of the bone
Silver staining spherical aggregation of tau protiens in neurons Pick bodies (Picks disease - progressive dementia, changes in personality)
"Spikes" on BM, "dome like" subepithelial deposits Membranous glomerulonephritis
Stacks of RBCs Rouleaux formation (high ESR, Multiple Myeloma)
"Tennis racket" shaped cytoplasmic organelles (EM) in Langerhans cells Bierbeck granules, histiocytosis X
Strippled vaginal epithelial cells "Clue cells" Gardnerella vaginalis
"Thumb" sign on lateral xray Epiglottitis (H influenzae)
Thrombi made of white/red layers Lines of Zahn (arterial thrombus, layers of platelets, RBCs)
Thyroid-like appearance of kidney Chronic bacterial pyelonephritis
"Tram track" appearance on LM Membranoproliferative glomerulonephritis
Triglyceride accumulation in liver cell vacuoles Fatty liver disease
WBCs that look smudged CLL (almost always B cell, affects elderly)
"Wire loop" glomerular appearance on LM Lupus nephropathy
Yellow CSF Xanthochromia (previous subarachnoid hemorrhage)
Created by: 092309