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70 Cards in this Set
- Front
- Back
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Acanthocyte (sput cell)
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Liver disease, abetalipoproteinemia
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Basophilic stipling
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Thalassemias, Anemia of chronic disease, Iron deficiency, Lead poisoning
TAIL |
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Bite cell
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G6PD deficiency
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Elliptocyte
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Hereditary elliptocytosis
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Marco-ovalocyte
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Megaloblastic anemia (also hypersegmented PMNs), marrow failure
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Ringed sideroblasts
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Sideroblastic anemia
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Schistocyte, helmet cell
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DIC, TTP/HUS, traumatic hemolysis
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Sickle cell
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Sickle cell anemia
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Spherocyte
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Hereidtary spherocytosis, AI hemolysis
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Teardrop cell
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bone marrow infiltration
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Target cell
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HbC disease, asplenia, liver disease, thalassemia
HALT |
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Heinz bodies
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oxidation of iron from ferrous to ferric form leads to denatured hemoglobin precipitation and damage to RBC membrane. Leads to formation of bite cells.
Alpha thalassemia and G6PD deficiency |
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Howell Jolly bodies
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Basophilic nuclear remnants found in RBC
hyposplenia or asplenia |
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Iron deficiency anemia lab values
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dec serum iron (primary)
Inc Transferrin or TIBC Dec ferritin substantially dec % transferrin saturation |
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Chronic disease lab values
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dec serum iron
dec transferrin or TIBC inc ferritin (primary) no change in % transferrin saturation |
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Hemochromatosis lab values
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no change in serum iron
inc transferrin or TIBC (primary) Inc ferritin substantially inc % transferin saturation |
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Pregnancy/OCP use
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no change serum iron
inc transferrin or TIBC (primary) no change ferritin dec % transferrin saturation |
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Lead poisoning
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inc serum iron
dec transferrin or TIBC no change ferritin inc % transferrin saturation |
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Types of microcytic, hypochromic (MCV <80) anemia
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Iron deficiency
Alpha thalassemia Beta thalassemia Lead poisoning Sideroblastic anemia |
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Lead poisoning findings
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Lead lines on gingivae (burton's lines) and on epiphyses of long bones on x ray
Encephalopathy and erythrocyte basophilic stippling Abdominal colic and sideroblastic anemia Drops: wrist and foot. Tx. Dimercaperol and EDTA for adults, Succimer for kids |
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Macocytic (MCV >100) anemia causes
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Impaired DNA synthesis --> maturation of nucleus delayed relative to maturation of cytoplasm. Ineffective erythropoiesis leads to pancytopenia.
Megaloblastic anemia caused by folate deficiency Megaloblastic anemia caused by B12 deficiency Megaloblastic anemia caused by orotic aciduria Nonmegaloblastic macrocytic anemia |
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Normocytic, normochromatic anemia types
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Intravascular hemolysis
Extravascular hemolysis |
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Non hemolytic, normocytic anemia types
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Anemia of chronic disease (ACD)
Aplastic anemia Kidney disease |
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Instrinsic hemolytic normocytic anemia types
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Herediatry spherocytosis
G6PD deficiency Pyruvate kinase deficiency (E) Sickle Cell anemia (E) HbC defect Paroxysmal noctural hemoglobinuria (I) |
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Extrinsic hemolytic normocytic anemia
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AI hemolytic anemia
Microagniopathic anemia (I) Macroangiopathic anemia Infections |
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Lead poisoning
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Affected enzyme: ferrochetalase and ALA dehydratase
Accumulated substance: protoporphyrin Sx: microcytic anemia. GI and renal disease kids --> exposure to lead pain --> mental deterioration adults --> environmental exposure (battery/ammunition/radiator factory) --> ha, memory loss, demyelination |
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Acute intermittent porphyria
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Affected enzyme: porphobilinogen deaminase (urophorphyrinogen I synthase)
accumulated substance: porphobilinogen, gama ALA, uroporphyrin SX; painful abdomen, red wine urine, polyneuropathy, psycholgoical disturbances, precipitated by drugs Tx: glucose and heme which inhibit ALA synthase |
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Porphyria Cutanea Tarda
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Affected enzyme: uroporphyrinogen decarboxylase
Accumulated substance: urophyrin (tea colored urine) Sx: blistering cutaneous photosensitivity, hypertrichosis, facial hyperpigmentaion, hep C, alcoholism, associated with inc LFTs (AST, ALT, GGT). Most common porphyria. |
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Hemophilia A or B labs
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no change PT, inc PTT
Mechanism: intrinsic pathway coagulation defect A: def in factor VIII --> Inc PTT B: def in factor IX --> inc PTT Macrohemoorahge in hemophilia - hemarthorses (bleeding into joints), easy bruising, PTT |
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Vit K deficiency labs
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Inc PT and PTT
General coagulation defect Dec synthesis of factors II, VII, IX, X, protein C and S (remember: disco started in 1972) |
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PT test
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tests function of factors I, II, V, VII, X (extrinsic pathway)
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PTT test
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tests function of all factors except VII and XIII (intrinsic pathway)
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Bernard soulier's disease
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Dec PC, inc BT
Defect in platelet plug formation Dec Gp1b --> defect in platelet to collagen adhesion |
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Glanzmann's thrombasthenia
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no change PC, inc BT
Defect in platelet plug formation Dec GpIIb/IIIa --> defect in platelet to platelet aggregation. Labs: blood smear shows no platelet clumping |
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Idiopathic thrombocytopenic purpura (ITP)
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dec PC, inc BT
Dec platelet survival Defect: anti GpIIb/IIIa ab's --> peripheral platelet destruction Labs: inc megakaryocytes Tx: steroids, IV Ig, splenectomy |
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Thrombotic Thrombocytopenic Purpura (TTP) --> HUS + fever, neuro
HUS: hemolysis, uremia, thrombocytopenia |
dec PC, inc BT
Dec platelet survival Def of ADAMTS 13 (vWF metalloproteinase) --> dec degredation of vWF multimers Pathogenesis: inc large vWF multimers --> inc platelet aggregation and thrombosis Labs: schisocytosis, inc LDH Symptoms: pentad of neuro and renal sx, fever, thrombocytopenia and microangiopathic hemolytic anemia |
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Aspirin labs
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no change PC, inc BT
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Direct Coombs + in
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Hemolytic dz of newborn, drug induced AI hemolytic anemia, hemolytic transfusion reactions
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Indirect Coombs + in
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Ab's present to foreign blood (used to test blood prior to transfusion, screening for maternal antibodies to a fetus' blood)
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Cold agglutinins
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IgM
M. pneumoniae, EBV, some malignancies |
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Warm agglutinins
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IgG
SLE CLL, NHL EBV, HIV Congenital immune abnormalities |
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Most common leukemia in kids
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ALL
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Most common leukemia in adults
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CLL
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Most common lymphoma in US
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Diffuse large B cell lymphoma
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Reed sternberg cells
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Hodgkin's lymphoma
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AML a/w Down's
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M7 AML
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Leukemia with more mature cells and less than 5% blasts
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Chronic leukemia
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AML that are CD13 and CD 33 +
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M0-M6 AML
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Particularly a/w EBV
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Burkitt's and Hodgkin's lympohmas
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Characteristic Auer rods
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AML M2 and M3
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A/w long term celiac disease
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Intestinal T cell lymphoma
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Greater than 20% blasts in marrow
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Acute leukemia
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Myelodysplastic syndrome have a tendency to progress to ---
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AML
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Myeloproliferative disorders may progress to ___
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AML
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AML that is CD 41 and CD 61+
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M7 AML
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PAS + acute leukemia
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ALL
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Commonly presents with bone pain
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ALL
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Viscous blood, headache, plethora, splenomegaly, and low erythropoietin
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Polycythemia vera
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Leukemia equivalent of Burkett's lymphoma
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L3 or B variant ALL
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Lymphoma equivalent of CLL
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Small lymphocytic lymphoma
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Numerous basophils, splenomegaly, and negative for leukocyte alkaline phosphatase (LAP)
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CML
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Most common neonatal leukemia
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M7 AML (megakaryocytic)
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Always positive for Philadelpha chromosome t(9;22)
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CML
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Only AML that is CD 13 and CD 33 -
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M7 AML
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Starry sky pattern due to phagocytosis of apoptotic tumor cells
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Burkitt's lymphoma
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Always associated with BCR ABL gene
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CML
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A/w Sjogren syndrome, Hashimoto's thyroiditis, and H. pylori
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Marginal cell MALToma
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Acute leukemia positive for peroxidas
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AML
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Solid sheets of lymphoblasts in marrow
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ALL
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PAS - acute leukemia
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AML
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