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41 Cards in this Set
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- Back
- 3rd side (hint)
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How do we define AIDS?
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+ HIV test AND
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one of the following: <200 CD4 T cells/microL, AIDS-defining opportunistic infection, AIDS associated malignancies, HIV complicating infections
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What does the bleeding time test?
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PLATELET function
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What does PT (prothrombin time) test?
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EXTRINSIC & COMMON PTHWY
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Factors: 7, 5, 2, 1
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What does PTT (partial thromboplastin time) test?
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INTRINSIC & COMMON PTHWY
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all factors except 7 and 13
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What does TT (thrombin time) test?
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COMMON PTHWY
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factors 2 and 1
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Which factors does Vitamin K mature?
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2, 7, 9, 10
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Which diseases are related to factor 8 deficiency or absence?
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deficiency--Von Willebrand Dz, absence--Hemophilia A
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**increased PTT
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What is DIC?
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spontaneous activation of coagulation cascade (w/ intravascular coagulation).
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initiated by--bacterial endotoxins, presence of dead tissue, AML. Labs: prolonged PT, PTT
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Why do we give Heparin with Warfarin?
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Because warfarin has a procoagulation effect during the first days. Heparin is given to act against it. It works faster, too.
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What are the causes of idiopathic thrombocytopenic purpura?
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Children: viral infection Adults: autoimmune
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What are the causes of thrombotic thrombocytopenic purpura?
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primary: autoimmune secondary: drugs-->clopidogrel, quinine, interferon alpha
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spontaneous platelet aggregation w/ systemic platelet clot formation and consumption of platelets
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What are shistocytes (helmet or bite cells) indicative of?
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damage, may see in thrombotic thrombocytopenic purpura
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What is spherocytosis?
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chronic dz characterized by hemolysis of spheroidal RBCs, anemia, splenomegaly.
Due to deficient spectrin. |
RBCs were sphere like, look 2-D
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What marker is used for ischemia?
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Lactate Dehydrogenase (LDH)
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oxygen can't enter the kreb cycle. Thus, after glycolysis-->pyruvate--(LDH)-->lactate (lactic acid)
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What is G6PD?
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x-linked recessive disorder, only way to make NADPH, RBC is very sensitive to oxidative damage.
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RBC lysis occurs due to exposure to excess radicals (fava beans, sulfa drugs, quinine derivatives)
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What is the defect in sickle cell anemia?
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autosomal recessive-->HbS. Single amino acid substitution (valine-->glutamate) in beta globin chain (at the 6th amino acid pxn)
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What kind of anemia results with hemogloblin pathology?
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MICROCYTIC ANEMIA
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What is thalassemia (alpha and beta)?
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ALPHA--decreased synthesis of alpha globin chains, BETA--decreased synthesis of beta globin chains
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Major beta--no alleles, SEVERE microcytic anemia. Minor beta--missing allele
**need alpha globins to survive |
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What type of anemia results from immune mediated hemolysis?
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normocytic, normochromic (normal platelets just not enough)
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antibodies against one's own RBCs
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What are the causes for warm agglutinin disease (immune mediated hemolysis)?
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Drugs (methyldopa, dopa, high dose penicillin, cephalosporin), malignancies (leukemia, lymphoma), SLE
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What are the causes for cold agglutinin disease (immune mediated hemolysis)?
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Mycoplasma pneumonia, mononucleosis, lymphoma, 50% idiopathic
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What is the Coombs test used for?
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detect autoantibodies to rbcs
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Direct: RBCs coated with antibodies (gold standard for immune mediated hemolysis) Indirect: free floating (isoimmunization in Rh- females)
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How do you know if the patient has a B12 or folate deficiency?
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B12- neurotoxic "be crazy", folate-no neuro. both will have megaloblastic anemia
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What are the clinical findings of megaloblastic anemia?
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defective DNA synthesis-->leukopenia, hypersegmented neutrophils, thrombocytopenia
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What are the causes of Vit B12 deficiency?
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malabsorption, diphyllobothrium latum (fish worm), lack of intrinsic factor (pernicious anemia, gastric bypass surgery), absence of terminal ileum (Crohns)
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Where do you see a folic acid deficiency?
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alcoholic and pregnant women
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What are the signs and symptoms of Plummer Vinson Syndrome?
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low grade, long term iron deficiency, esophageal webs, dysphagia for SOLIDS ONLY
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What is Fanconi anemia?
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recessive, inability to remove oxygen radicals from bone marrow
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clincal findings: microcephaly, cafe au lait spots, small or absent thumbs, deformed or absent radius bones, recurrent aplastic anemia (bm failure), HIGH risk of leukemia or lymphoma
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What are bite cells and heinz bodies (denatured hemoglobin) indicative of?
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G6PD deficiency
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What is indicative of basophilic stippling?
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lead poisioning
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What is Howell-Joly bodies indicative of?
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immature RBCs leaving the bone marrow, hyposplenia or asplenia
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What are siderocytes?
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extra iron in RBC, due BM problems
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What are reticulocytes
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immature RBCS,
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What is a cause of increased destruction of neutrophils?
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Felty's syndrome--variant of rheumatoid arthritis, immune mediated destruction of neutrophils (anti-neutrophil antibodies)
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What are some causes of a high number of wbcs (leukocytosis)?
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"Neutrophils Like Making Everything Better" Neutrophils, Lymphocytes, Monocytes, Eosinophils, Basophils
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What is a sign of acute myelogenous leukemia?
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Auer rods, evidence of myeloid proliferation
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What is the genetic abnormality assoc with chronic myelogenous leukemia?
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Philadelphia Chromosome (9:22), translocation, bcr-abl fusion gene is created
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low Leukocyte Alkaline Phosphatase
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What are the markers for Hairy Cell Leukemia?
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+ TRAP (tartrate-R-acid-phosphatase), CD25 markers present
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"Harry was a 25 yo TRAP", B cell only, splenomegaly
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What is indicative of Hodgkin's Disease (lymphoma, solid tumor)?
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+ Reed Sternberg Cells
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What are the 4 subtypes of Hodgkins Lymphoma?
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BEST-->WORST prognosis. lymphocyte predominance-->nodular sclerosis-->mixed cellularity-->lymphocyte depletion (increased RS cells)
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What is non-hodgkins lymphoma associated with?
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bcl-2
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