Diag Exam 3 Ppt 2

Front 1

What does purpura mean?

Back 1

bleeding into the skin

Front 2

Leukemic blasts and low platelet count suggests what?

Back 2

acute leukemia

Front 3

What clinically happens when bone marrow fails to produce normal blood cells at the correct rate?

Back 3

neutrophil count falls first, then platelets and then RBCs

Front 4

What fundamental change is taking place in the bone marrow in acute leukemia?

Back 4

leukemic cells fail to differentiate and also have reduced rate of apoptosis

Front 5

Why are the cells in marrow affected in leukemia?

Back 5

leukemic cless inhibit the development of normal cell differentiation in the non-involved cells in the bone marrow, probably by releasing cytokines

Front 6

A high cell turnover rate will result in what?

Back 6

elevated LDH and urate and cause renal impairment, leading to a high creatinine

Front 7

What is the appearance of keukemic cells on a slide?

Back 7

morphology

Front 8

What are special stains to try to identify primitve cell constituents, which might provide a clue as to the possible differentiation pathway that had been blocked in that cell?

Back 8

cytochemistry

Front 9

What is a study of the surface antigens on the leukemic cells?

Back 9

flow cytometry

Front 10

What is a determination of the aberrant genetic material in the leukemic cell?

Back 10

cytogenetics

Front 11

What is the study of the DNA of the leukemic cell. This is also useful to track the patient after therapy to see if the leukemic has been eradicated?

Back 11

molecular genetics

Front 12

Hb-increased
MCV-decreased
RBC-increased
WBC-increased
Plateletes-increaed
Uric Acid-increased
What could all these findings mean?

Back 12

-raised Hb and RBC means erythrocytosis
-raised platelet could mean bone marrow problem cuasing an excess production of RBCs and platelets
-large spleen-suggests that there is some fundamental disturbance of hematologoic system
-raised Uric Acid-may reflect idiopathic hyperuricemia or increased cell turnover

Front 13

If there is a hypoxemic state, the levels of the EPO are what?

Back 13

elevated, which reflects the increased drive to produce RBCs

Front 14

In polycythemia rubra vera, the serum levels of EP are usually what?

Back 14

normal or decreased

Front 15

Where does EPO come from?

Back 15

Produced in the kidney by peritubular fibroblasts in the renal cortex. It is synthesized by renal peritubular cells in adults, with a small amount being produced in the liver

Front 16

EPO has its primary effects on what?

Back 16

RBCs by promoting red cell survival by protecting these cells from apoptosis

Front 17

What is the tx for polycythemia?

Back 17

phlebotomy

Front 18

What is the connection btw increased number of platelet precursors and no abnormal cells?

Back 18

The increased number of megakaryocytes in the bone marrow suggests that plaelet production is normal. The decreased number of platelet in the blood suggests that there is premature destruction of platelets. Platelet numbers may be decreased in the presence of a large spleen as pooling may occur.

Front 19

What is the cause of ITP?

Back 19

An autobody is formed against a protein on the platelet membrane for no known reason.

Front 20

What drugs can commonly cause low platelet count?

Back 20

-Quinine
-Bactrim
-rifampin

Front 21

The finding of an enlarged spleen in a patient with a low platelet count indicates what?

Back 21

ITP