First Aid: Usmle - Lab/diagnostic Findings | Diagnosis/disease

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Anticentromere antibodies

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Scleroderma (CREST [calcinosis, Raynaud's phenomenon,esophageal dysmotility, sclerodactyly andtelangiectasia])

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Antidesmoglein (epithelial) antibodies

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Pemphigus vulgaris (blistering)

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Anti–glomerular basement membrane antibodies

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Goodpasture syndrome (glomerulonephritis and hemoptysis, crescent)

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Antihistone antibodies

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Drug-induced SLE (hydralazine, INH, phenytoin, procainamide)

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Anti-IgG antibodies

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Rheumatoid arthritis (systemic inflammation, joint pannus, boutonnière deformity)

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Antimitochondrial antibodies (AMAs)

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1° biliary cirrhosis (female, cholestasis, portal hypertension)

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Antineutrophil cytoplasmic antibodies (ANCAs)

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Microscopic polyangiitis and Churg-Strauss syndrome (MPO-ANCA/p-ANCA); granulomatosis with polyangiitis (Wegener; PR3-ANCA/c-ANCA)

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Antinuclear antibodies (ANAs: anti-Smith and anti-dsDNA)

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SLE (type III hypersensitivity)

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Antiplatelet antibodies

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Idiopathic thrombocytopenic purpura

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Anti-topoisomerase antibodies

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Diffuse systemic scleroderma

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Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies

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Celiac disease (diarrhea, distention, weight loss)

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“Apple core” lesion on abdominal x-ray

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Colorectal cancer (usually left-sided)

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Azurophilic peroxidase + granular inclusions in granulocytes and myeloblasts

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Auer rods (AML, especially the promyelocytic [M3] type)

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Bacitracin response

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Sensitive: Streptococcus pyogenes (group A); resistant: Streptococcus agalactiae (group B)

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“Bamboo spine” on x-ray

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Ankylosing spondylitis (chronic inflammatory arthritis: HLA-B27)

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Basophilic nuclear remnants in RBCs

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Howell-Jolly bodies (due to splenectomy or nonfunctional spleen)

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Basophilic stippling of RBCs

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Lead poisoning or sideroblastic anemia

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Bloody tap on LP

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Subarachnoid hemorrhage

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“Boot-shaped” heart on x-ray

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Tetralogy of Fallot, RVH

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Branching gram-positive rods with sulfur granules

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Actinomyces israelii

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Bronchogenic apical lung tumor on imaging

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Pancoast tumor (can compress sympathetic ganglion and cause Horner syndrome)

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“Brown” tumor of bone

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Hyperparathyroidism or osteitis fibrosa cystica (deposited hemosiderin from hemorrhage gives brown color)

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Cardiomegaly with apical atrophy

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Chagas disease (Trypanosoma cruzi)

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Cellular crescents in Bowman capsule

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Rapidly progressive crescentic glomerulonephritis

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“Chocolate cyst” of ovary

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Endometriosis (frequently involves both ovaries)

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Circular grouping of dark tumor cells surrounding pale neurofibrils

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Homer-Wright rosettes (neuroblastoma, medulloblastoma, retinoblastoma)

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Colonies of mucoid Pseudomonas in lungs

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Cystic fibrosis (autosomal recessive mutation in CFTR gene fat-soluble vitamin deficiency and mucous plugs)

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Decreased AFP (alpha fetoprotein) in amniotic fluid/maternal serum

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Down syndrome or other chromosomal abnormality

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Degeneration of dorsal column nerves

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Tabes dorsalis (3° syphilis), subacute combined degeneration (dorsal columns and lateral corticospinal tracts affected)

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Depigmentation of neurons in substantia nigra

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Parkinson disease (basal ganglia disorder: rigidity, resting tremor, bradykinesia)

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Desquamated epithelium casts in sputum

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Curschmann spirals (bronchial asthma; can result in whorled mucous plugs)

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Disarrayed granulosa cells in eosinophilic fluid

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Call-Exner bodies (granulosa-theca cell tumor of the ovary)

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Dysplastic squamous cervical cells with nuclear enlargement and hyperchromasia

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Koilocytes (HPV: predisposes to cervical cancer)

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Enlarged cells with intranuclear inclusion bodies

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“Owl eye” appearance of CMV

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Enlarged thyroid cells with ground-glass nuclei

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“Orphan Annie” eyes nuclei (papillary carcinoma of the thyroid)

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Eosinophilic cytoplasmic inclusion in liver cell

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Mallory body (alcoholic liver disease)

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Eosinophilic cytoplasmic inclusion in nerve cell

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Lewy body (Parkinson disease)

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Eosinophilic globule in liver

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Councilman body (toxic or viral hepatitis, often yellow fever)

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Eosinophilic inclusion bodies in cytoplasm of hippocampal and cerebellar nerve cells

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Negri bodies of rabies

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Extracellular amyloid deposition in gray matter of brain

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Senile plaques (Alzheimer disease)

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Giant B cells with bilobed nuclei with prominent inclusions (“owl’s eye”)

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Reed-Sternberg cells (Hodgkin lymphoma)

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Glomerulus-like structure surrounding vessel in germ cells

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Schiller-Duval bodies (yolk sac tumor)

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“Hair on end” (crew-cut) appearance on x-ray

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β-thalassemia, sickle cell anemia (marrow expansion)

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hCG elevated

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Choriocarcinoma, hydatidiform mole (occurs with and without embryo, and multiple pregnancy)

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Heart nodules (granulomatous)

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Aschoff bodies (rheumatic fever)

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Heterophile antibodies

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Infectious mononucleosis (EBV)

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Hexagonal, double-pointed, needle-like crystals in bronchial secretions

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Bronchial asthma (Charcot-Leyden crystals: eosinophilic granules)

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High level of d-dimers

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DVT, PE, DIC

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Hilar lymphadenopathy, peripheral granulomatous lesion in middle or lower lung lobes (can calcify)

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Ghon complex (1° TB: Mycobacterium bacilli)

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“Honeycomb lung” on x-ray or CT

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Interstitial pulmonary fibrosis

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Hypercoagulability (leading to migrating DVTs and vasculitis)

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Trousseau syndrome (adenocarcinoma of pancreas or lung)

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Hypersegmented neutrophils

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Megaloblastic anemia (B12 deficiency: neurologic symptoms; folate deficiency: no neurologic symptoms)

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Hypertension, hypokalemia, metabolic alkalosis

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Conn syndrome

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Hypochromic, microcytic anemia

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Iron deficiency anemia, lead poisoning, thalassemia (fetal hemoglobin sometimes present)

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Increased AFP (alpha-fetoprotein) in amniotic fluid/maternal serum

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Dating error, anencephaly, spina bifida (neural tube defects)

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Increased uric acid levels

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Gout

Lesch-Nyhan syndrome

Tumor lysis syndrome

Loop and thiazide diuretics

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Intranuclear eosinophilic droplet-like bodies

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Cowdry type A bodies (HSV or CMV)

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Iron-containing nodules in alveolar septum

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Ferruginous bodies (asbestosis:chance of mesothelioma)

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Keratin pearls on a skin biopsy

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Squamous cell carcinoma

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Large lysosomal vesicles in phagocytes, immunodeficiency

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Chédiak-Higashi disease (congenital failure of phagolysosome formation)

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“Lead pipe” appearance of colon on barium enema x-ray

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Ulcerative colitis (loss of haustra)

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Linear appearance of IgG deposition on glomerular basement membrane

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Goodpasture syndrome

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Low serum ceruloplasmin (Ceruloplasmin is the majorcopper-carrying protein in the blood, and in addition plays a role in iron metabolism)

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Wilson disease (hepatolenticular degeneration)

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“Lumpy bumpy” appearance of glomeruli on immunofluorescence

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Poststreptococcal glomerulonephritis (immune complex deposition of IgG and C3b)

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Lytic (“hole punched”) bone lesions on x-ray

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Multiple myeloma

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Mammary gland (“blue domed”) cyst

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Fibrocystic change of the breast

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Monoclonal antibody spike

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Multiple myeloma (usually IgG or IgA)

Monoclonal gammopathy of undetermined significance (MGUS consequence of aging)

Waldenström (M protein = IgM) macroglobulinemia

Primary amyloidosis

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Mucin-filled cell with peripheral nucleus

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“Signet ring” (gastric carcinoma)

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Narrowing of bowel lumen on barium x-ray

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“String sign” (Crohn disease)

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Necrotizing vasculitis (lungs) and necrotizing glomerulonephritis

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Granulomatosis with polyangiitis (Wegener; PR3-ANCA/ c-ANCA) and Goodpasture syndrome (anti–basement membrane antibodies)

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Needle-shaped, negatively birefringent crystals

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Gout (monosodium urate crystals)

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Nodular hyaline deposits in glomeruli

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Kimmelstiel-Wilson nodules (diabetic nephropathy)

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Novobiocin response

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Sensitive: Staphylococcus epidermidis

Resistant: Staphylococcus saprophyticus

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“Nutmeg” appearance of liver

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Chronic passive congestion of liver due to right heart failure

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“Onion skin” periosteal reaction

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Ewing sarcoma (malignant round-cell tumor)

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Optochin response

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Sensitive: Streptococcus pneumoniae

Resistant: viridans streptococci

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Periosteum raised from bone, creating triangular area

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Codman triangle on x-ray (osteosarcoma, Ewing sarcoma, pyogenic osteomyelitis)

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Podocyte fusion or “effacement” on electron microscopy

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Minimal change disease (child with nephrotic syndrome)

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Polished, “ivory-like” appearance of bone at cartilage erosion

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Eburnation (osteoarthritis resulting in bony sclerosis)

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Protein aggregates in neurons from hyperphosphorylation of tau protein

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Neurofibrillary tangles (Alzheimer disease) and Pick bodies (Pick disease)

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Psammoma bodies

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Meningiomas, papillary thyroid carcinoma, mesothelioma, papillary serous carcinoma of the endometrium and ovary

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Pseudopalisading tumor cells on brain biopsy

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Glioblastoma multiforme

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RBC casts in urine

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Acute glomerulonephritis

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Rectangular, crystal-like, cytoplasmic inclusions in Leydig cells

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Reinke crystals (Leydig cell tumor)

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Renal epithelial casts in urine

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Acute toxic/viral renal injury

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Rhomboid crystals, positively birefringent

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Pseudogout (calcium pyrophosphate dihydrate crystals)

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Rib notching

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Coarctation of the aorta

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Ring-enhancing brain lesion in AIDS

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Toxoplasma gondii, CNS lymphoma

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Sheets of medium-sized lymphoid cells with scattered pale, tingible body–laden macrophages (“starry sky” histology)

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Burkitt lymphoma (t[8:14] c-myc activation, associated with EBV; “black sky” made up of malignant cells)

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Silver-staining spherical aggregation of tau proteins in neurons

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Pick bodies (Pick disease: progressive dementia, changes in personality)

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“Soap bubble” in femur or tibia on x-ray

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Giant cell tumor of bone (generally benign)

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“Spikes” on basement membrane, “dome-like” subepithelial deposits

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Membranous glomerulonephritis (may progress to nephrotic syndrome)

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Stacks of RBCs

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Rouleaux formation (high ESR, multiple myeloma)

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Stippled vaginal epithelial cells

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“Clue cells” (Gardnerella vaginalis)

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“Tennis racket”-shaped cytoplasmic organelles (EM) in Langerhans cells

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Birbeck granules (Langerhans cell histiocytosis or histiocytosis X: eosinophilic granuloma)

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Thrombi made of white/red layers

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Lines of Zahn (arterial thrombus, layers of platelets/RBCs)

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“Thumb sign” on lateral x-ray

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Epiglottitis (Haemophilus influenzae)

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Thyroid-like appearance of kidney

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Chronic bacterial pyelonephritis

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“Tram-track” appearance of capillary loops of glomerular basement membranes on light microscopy

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Membranoproliferative glomerulonephritis

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Triglyceride accumulation in liver cell vacuoles

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Fatty liver disease (alcoholic or metabolic syndrome)

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“Waxy” casts with very low urine flow

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Chronic end-stage renal disease

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WBC casts in urine

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Acute pyelonephritis

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WBCs that look “smudged”

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CLL (chronic lymphocytic leukemia), almost always B cell

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“Wire loop” glomerular capillary appearance on light microscopy

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Lupus nephropathy

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Yellowish CSF

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Xanthochromia (e.g., due to subarachnoid hemorrhage)