First Aid Rapid Review - Classic Labs, Findings

mlinnie's version from 2018-11-09 22:49

Lab/diagnostic finding

Question Answer
Anti-centromere Absscleroderma (CREST)
Antidesmoglein (epithelial) Abspemphigus vulgaris (blistering)
Anti-GBM AbsGoodpasture's syndrome (glomerulonephritis & hemoptysis)
Antihistone AbsDrug-induced SLE (hydralazine, isoniazid, phenytoin, procainamide)
Anti-IgG AbsRA (systemic inflammation, joint pannus, boutonniere deformity)
Antimitochondrial Abs (AMAs)1* biliary cirrhosis [PBC] (female, cholestasis, portal hypertension)
Antineutrophil cytoplasmic Abs (ANCAs)vasculitis (c-ANCA: Wegener's; p-ANCA: microscopic polyangiitis, Churg-Strauss syndrome)
Antinuclear Abs (ANAs: anti-Smith & anti-dsDNA)SLE (type III hypersensitivity)
Antiplatelet Absidiopathic thrombocytopenic purpura (ITP)
Anti-topoisomerase Absscleroderma (diffuse systemic)
Anti-transglutaminase/anti-gliadin/anti-endomysial AbsCeliac disease (diarrhea, distention, weight loss)
"Apple core" lesion on abd x-raycolorectal cancer (usually L-side)
Azurophilic granular needles in leukemic blastsAuer rods (AML, esp the promyelocytic [M3] type)
Bacitracin responsesensitive: Strep pyogenes (group A)
resistant: Strep agalactiae (group B)
"Bamboo spine" on xrayankylosing spondylitis (chronic inflammatory arthritis: HLA-B27)
Basophilic nuclear remnants in RBCsHowell-Jolly bodies (due to splenectomy or nonfunctional spleen)
Basophilic stippling of RBCslead poisoning or sideroblastic anemia
Bloody tap on LPsubarachnoid hemorrhage
"Boot-shaped" heart on xraytetralogy of Fallot, RVH
Branching Gm+ rods w/ sulfur granulesActinomyces israelii
Bronchogenic apical lung tumorPancoast tumor (can compress sympathetic ganglion and cause Horner's syndrome)
"Brown" tumor of boneHemorrhage (hemosiderin) causes brown color of osteolytic cysts, due to hyperparathyroidism (osteitis fibrosa cystica)
Cardiomegaly w/ apical atrophyChagas disease
Cellular crescents in Bowman's capsuleRapidly progressive crescentic glomerulonephritis
"Chocolate cyst" of ovaryendometriosis (frequently involves both ovaries)
Circular grouping of dark tumor cells surrounding pale neurofibrilsHomer Wright rosettes (neuroblastoma, medulloblastoma, retinoblastoma)


Question Answer
Colonies of mucoid Pseudomonas in lungsCystic fibrosis (AR mutation to CFTR resulting in fat-soluble vitamin def & mucous plugs)
Decreased α-fetoprotein in amniotic fluid/maternal serumDown syndrome or other chromosomal abnormality
Degeneration of dorsal column nervesTabes dorsalis (3* syphilis)
Depigmentation of neurons in substantia nigraParkinson's disease (basal ganglia disorder: rigidity, resting tremor, akinesia, postural instability)
Desquamated epithelium casts in sputumCurschmann's spirals (bronchial asthma; can result in whorled mucous plugs)
Disarrayed granulosa cells in eosinophilic fluidCall-Exner bodies (granulosa-theca cell tumor of the ovary)
Dysplastic squamous cervical cells with nuclear enlargement & hyperchromasiaKoilocytes (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" eye nuclei (papillary carcinoma of the thyroid)
Eosinophilic cytoplasmic inclusion in liver cellMallory bodies (alcoholic liver disease)
Eosinophilic cytoplasmic inclusion in nerve cellLewy body (Parkinson's disease)
Eosinophilic globule in liverCouncilman body (toxic or viral hepatitis, often yellow fever)
Eosinophilic inclusion bodies in cytoplasm of hippocampal nerve cellsNegri bodies [rabies virus (Lyssavirus)]
Extracellular amyloid deposition in gray matter of brainsenile plaques (Alzheimer's disease)
Giant B cells w/ bilobed nuclei w/ prominent inclusions ("owl's eye")Reed-Sternberg cells (Hodgkin's lymphoma)
Glomerulus-like structure surrounding vessel in germ cellsSchiller-Duval bodies (yolk sac tumor)
"Hair-on-end" (crew-cut) appearance on head x-rayβ-thalassemia, sickle cell anemia (marrow expansion -> accentuated vertical trabeculae)
hCG elevatedchoriocarcinoma, hydatidiform mole (occurs w/ and w/o embryo)
Heart nodules (granulomatous)Aschoff bodies (rheumatic fever), contain Anitschkow cells (enlarged macrophages w/ "caterpillar" nuclei)
Heterophile Absmonospot test: infectious mononucleosis (EBV)
Hexagonal, double-pointed, needle-like crystals in bronchial secretionsbronchial asthma (Charcot-Leyden crystals: eosinophilic granules)
High level of D-dimersDVT, pulmonary embolism, DIC
Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify)Ghon complex (1* TB: Mycobacterium bacilli)
"Honeycomb lung" on x-rayinterstitial fibrosis
Hypersegmented neutrophilsmegaloblastic anemia (B12 def: neurologic symptoms; folate def: no neurologic symptoms)
Hypochromic, microcytic anemiairon def anemia, lead poisoning, thalassemia (HbF sometimes present)
Increased α-fetoprotein in amniotic fluid/maternal serumdating error, anencephaly, spina bifida (neural tube defects)
Increased uric acid levelsgout, Lesch-Nyhan syndrome, tumor lysis syndrome, loop & thiazide diuretics


Question Answer
Intranuclear eosinophilic droplet-like bodiesCowdry type A bodies (HSV or CMV)
Iron-containing nodules in alveolar septumFerruginous bodies (asbestosis: increased chance of mesothelioma)
Large lysosomal vesicles in phagocytes, immunodeficiencyChediak-Higashi disease (congenital failure of phagolysosome formation)
"Lead pipe" appearance of colon on x-rayUlcerative colitis (loss of haustra)
Linear appearance of glomeruli on immunofluorescenceGoodpasture's syndrome
Low serum ceruloplasminWilson's disease (hepatolenticular degeneration)
"Lumpy-bumpy" appearance of glomeruli on immunofluorescencePost-streptococcal glomerulonephritis (immune complex deposition of IgG and C3b)
Lytic ("hole-punched") bone lesions on x-rayMultiple myeloma
Mammary gland ("blue-domed") cystFibrocystic change of the breast
Monoclonal antibody spike1. 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) macroglobulinemia
4. Primary amyloidosis
Monoclonal globulin protein in blood/urineBence Jones proteins (multiple myeloma [kappa or lambda Ig light chains in urine]), Waldenstrom's macroglobulinemia (IgM)
Mucin-filled cell with peripheral nucleusSignet ring (gastric carcinoma)
Narrowing of bowel lumen on barium radiograph"String sign" (Crohn's disease)
Needle-shaped, negatively birefringent crystalsGout (monosodium urate crystals)
Nodular hyaline deposits in glomeruliKimmelstiel-Wilson nodules (diabetic nephropathy)
Novobiocin responseResistant - Staphylococcus saprophyticus; Sensitive - Staphylococcus epidermidis; (No StRES)
"Nutmeg" appearance of liverChronic passive congestion of liver due to R-heart failure
"Onion-skin" periosteal reactionEwing's sarcoma (malignant round-cell tumor)
Optochin responseResistant - Viridans streptococcus; Sensitive - Streptococcus pneumoniae; (OVRPS)
Periosteum raised from bone, creating triangular areaCodman's triangle on x-ray (osteosarcoma, Ewing's sarcoma, pyogenic osteomyelitis)
Podocyte fusion on EMMinimal change disease (child w/ nephrotic syndrome)
Polished, "ivory-like" appearance of bone at cartilage erosionEburnation (osteoarthritis resulting in bony sclerosis)
Protein aggregates in neurons from hyperphosphorylation of protein tauNeurofibrillary tangles (Alzheimer's disease and CJD)
Pseudopalisading tumor cells on brain biopsyGlioblastoma multiforme
RBC casts in urineAcute glomerulonephritis
Rectangular, crystal-like, cytoplasmic inclusions in Leydig cellsReinke crystals (Leydig cell tumor)
Renal epithelial casts in urineAcute toxic/viral nephrosis


Question Answer
Rhomboid crystals, positively birefringentPseudogout (calcium pyrophosphate dihydrate)
Rib notchingCoarctation of the aorta
Ring-enhancing brain lesion in AIDSToxoplasma gondii
Sheets of medium-sized lymphoid cells ("starry sky" appearance on histology)Burkitt's lymphoma (t[8:14] c-myc activation, associated with EBV; "black sky" made up of malignant cells)
Silver-staining spherical aggregation of tau proteins in neuronsPick bodies (Pick's disease: progressive dementia, changes in personality)
"Soap bubble" in femur or tibia on x-rayGiant cell tumor of bone
"Spikes" on basement membrane, "dome-like" subepithelial depositsMembranous glomerulonephritis (may progress to nephrotic syndrome)
Stacks of red blood cellsRouleaux formation (high ESR, multiple myeloma)
Stippled vaginal epithelial cells"Clue cells" (Gardnerella vaginalis)
"Tennis-racket"-shaped cytoplasmic organelles (EM) in Langerhans cellsBirbeck granules (histiocytosis X: eosinophilic granuloma)
Thrombi made of white/red layersLines of Zahn (arterial thrombus, layers of platelets/RBCs)
"Thumb sign" on lateral x-rayEpiglottitis (Haemophilus influenzae)
Thyroid-like ("thyroidization") appearance of kidneyChronic bacterial pyelonephritis
"Tram-track" appearance on LMMembranoproliferative glomerulonephritis
Triglyceride accumulation in liver cell vacuolesFatty liver disease (alcoholic or metabolic syndrome)
WBCs that look "smudged"CLL (almost always B cell; affects the elderly)
"Wire loop" glomerular appearance on LMLupus nephropathy
Yellow CSFXanthochromia (previous subarachnoid hemorrhage)