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41 Cards in this Set

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How do we define AIDS?
+ HIV test AND
one of the following: <200 CD4 T cells/microL, AIDS-defining opportunistic infection, AIDS associated malignancies, HIV complicating infections
What does the bleeding time test?
PLATELET function
What does PT (prothrombin time) test?
EXTRINSIC & COMMON PTHWY
Factors: 7, 5, 2, 1
What does PTT (partial thromboplastin time) test?
INTRINSIC & COMMON PTHWY
all factors except 7 and 13
What does TT (thrombin time) test?
COMMON PTHWY
factors 2 and 1
Which factors does Vitamin K mature?
2, 7, 9, 10
Which diseases are related to factor 8 deficiency or absence?
deficiency--Von Willebrand Dz, absence--Hemophilia A
**increased PTT
What is DIC?
spontaneous activation of coagulation cascade (w/ intravascular coagulation).
initiated by--bacterial endotoxins, presence of dead tissue, AML. Labs: prolonged PT, PTT
Why do we give Heparin with Warfarin?
Because warfarin has a procoagulation effect during the first days. Heparin is given to act against it. It works faster, too.
What are the causes of idiopathic thrombocytopenic purpura?
Children: viral infection Adults: autoimmune
What are the causes of thrombotic thrombocytopenic purpura?
primary: autoimmune secondary: drugs-->clopidogrel, quinine, interferon alpha
spontaneous platelet aggregation w/ systemic platelet clot formation and consumption of platelets
What are shistocytes (helmet or bite cells) indicative of?
damage, may see in thrombotic thrombocytopenic purpura
What is spherocytosis?
chronic dz characterized by hemolysis of spheroidal RBCs, anemia, splenomegaly.

Due to deficient spectrin.
RBCs were sphere like, look 2-D
What marker is used for ischemia?
Lactate Dehydrogenase (LDH)
oxygen can't enter the kreb cycle. Thus, after glycolysis-->pyruvate--(LDH)-->lactate (lactic acid)
What is G6PD?
x-linked recessive disorder, only way to make NADPH, RBC is very sensitive to oxidative damage.
RBC lysis occurs due to exposure to excess radicals (fava beans, sulfa drugs, quinine derivatives)
What is the defect in sickle cell anemia?
autosomal recessive-->HbS. Single amino acid substitution (valine-->glutamate) in beta globin chain (at the 6th amino acid pxn)
What kind of anemia results with hemogloblin pathology?
MICROCYTIC ANEMIA
What is thalassemia (alpha and beta)?
ALPHA--decreased synthesis of alpha globin chains, BETA--decreased synthesis of beta globin chains
Major beta--no alleles, SEVERE microcytic anemia. Minor beta--missing allele
**need alpha globins to survive
What type of anemia results from immune mediated hemolysis?
normocytic, normochromic (normal platelets just not enough)
antibodies against one's own RBCs
What are the causes for warm agglutinin disease (immune mediated hemolysis)?
Drugs (methyldopa, dopa, high dose penicillin, cephalosporin), malignancies (leukemia, lymphoma), SLE
What are the causes for cold agglutinin disease (immune mediated hemolysis)?
Mycoplasma pneumonia, mononucleosis, lymphoma, 50% idiopathic
What is the Coombs test used for?
detect autoantibodies to rbcs
Direct: RBCs coated with antibodies (gold standard for immune mediated hemolysis) Indirect: free floating (isoimmunization in Rh- females)
How do you know if the patient has a B12 or folate deficiency?
B12- neurotoxic "be crazy", folate-no neuro. both will have megaloblastic anemia
What are the clinical findings of megaloblastic anemia?
defective DNA synthesis-->leukopenia, hypersegmented neutrophils, thrombocytopenia
What are the causes of Vit B12 deficiency?
malabsorption, diphyllobothrium latum (fish worm), lack of intrinsic factor (pernicious anemia, gastric bypass surgery), absence of terminal ileum (Crohns)
Where do you see a folic acid deficiency?
alcoholic and pregnant women
What are the signs and symptoms of Plummer Vinson Syndrome?
low grade, long term iron deficiency, esophageal webs, dysphagia for SOLIDS ONLY
What is Fanconi anemia?
recessive, inability to remove oxygen radicals from bone marrow
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
What are bite cells and heinz bodies (denatured hemoglobin) indicative of?
G6PD deficiency
What is indicative of basophilic stippling?
lead poisioning
What is Howell-Joly bodies indicative of?
immature RBCs leaving the bone marrow, hyposplenia or asplenia
What are siderocytes?
extra iron in RBC, due BM problems
What are reticulocytes
immature RBCS,
What is a cause of increased destruction of neutrophils?
Felty's syndrome--variant of rheumatoid arthritis, immune mediated destruction of neutrophils (anti-neutrophil antibodies)
What are some causes of a high number of wbcs (leukocytosis)?
"Neutrophils Like Making Everything Better" Neutrophils, Lymphocytes, Monocytes, Eosinophils, Basophils
What is a sign of acute myelogenous leukemia?
Auer rods, evidence of myeloid proliferation
What is the genetic abnormality assoc with chronic myelogenous leukemia?
Philadelphia Chromosome (9:22), translocation, bcr-abl fusion gene is created
low Leukocyte Alkaline Phosphatase
What are the markers for Hairy Cell Leukemia?
+ TRAP (tartrate-R-acid-phosphatase), CD25 markers present
"Harry was a 25 yo TRAP", B cell only, splenomegaly
What is indicative of Hodgkin's Disease (lymphoma, solid tumor)?
+ Reed Sternberg Cells
What are the 4 subtypes of Hodgkins Lymphoma?
BEST-->WORST prognosis. lymphocyte predominance-->nodular sclerosis-->mixed cellularity-->lymphocyte depletion (increased RS cells)
What is non-hodgkins lymphoma associated with?
bcl-2