Fa Hematology

Front 1

Anemia presenting with increased TIBC, decreased ferritin, decreased serum iron.

Back 1

Mycrocytic, Hypochromic, usually secondary to iron deficiency. Also seen with Thalassemia, lead poisoning

Front 2

Anemia in patients with B12/Folate deficiency

Back 2

Macrocytic (MCV>100), presents with PMN hypersegmentation on blood smear. B12 deficiency presents with neuro effects(not Folate), folate deficiency much easily reached through bad diet.
Shows marked reticulocytosis
Also seen in patients taking drugs blocking DNA synthesis (sulfa drugs, AZT)

Front 3

Anemia in patients with normocytic, normochromic smears?

Back 3

Hemorrhagic, autoimmune hemolytic, enzyme defects (G6PD), bone marrow dz, anemia of chronic dz. Decreased serum haptoglobin and increased LDH indicate RBC hemolysis. Direct Coomb's test can show an immune-mediated process.

Front 4

Anemia in patients with a decreased TIBC, decreased serum iron, and decreased iron saturation?

Back 4

Anemia of chronic disease

Front 5

Anemia in patients with an increased TIBC, decreased serum iron, and normal iron saturation?

Back 5

Iron-deficiency anemia.

Front 6

Patient with normal TIBC, increased serum iron, and 100% iron saturation (normal is 20-50%)

Back 6

Iron overload (hemosiderosis)

Front 7

What is Aplastic Anemia?

Back 7

Patients with pancytopenia characterized by severe anemia, neutropenia, and thrombocytopenia caused by failure or destruction of multipotent myeloid stem cells.

Front 8

Aplastic Anemia: What causes aplastic anemia?

Back 8

Radiation, benzene, chloramphenicol, alkylating agents, antimetabolites, viral agents, Fanconi's anemia, idiopathic causes.

Front 9

Aplastic Anemia: Common Sx?

Back 9

Fatigue, malaise, pallor, purpura, mucosal bleeding, petechiae, infection.

Front 10

Aplastic Anemia: How do the blood smear and bone marrow aspirate appear?

Back 10

Blood smear: pancytopenia with normal cell morphology. Aspirate:hypocellular marrow with fatty infiltration.

Front 11

Aplastic Anemia: What's the treatment of aplastic anemia?

Back 11

Withdraw offending agent, BMT, RBC/platelet transfusion, G-CSF or GM-CSF.

Front 12

Hereditary Spherocytosis: How do patients with hereditary psherocytosis present (smear and labs)?

Back 12

Smear shows microcytic RBCs that are small and round with no central pallor. The patients will have normal Hgb and MCV.

Front 13

Hereditary Spherocytosis: What's the cause of hereditary spherocytosis?

Back 13

Intravascular hemolysis due to spectrin defect.

Front 14

Hereditary Spherocytosis: How is it confirmed and tested?

Back 14

Will be Coombs' negative (unlike warm antibody hemolysis), can perform osmotic fragility test.

Front 15

Hereditary Spherocytosis: What are some associated diseases?

Back 15

Gallstones, splenomegaly, anemia, and jaundice.

Front 16

Blood Dyscrasias-Sickle Cell Anemia: What is the HbS mutation?

Back 16

Glutamate-->Valine in a Beta chain. Heterozygotes are usually malaria-resistant. *% of Af-Ams carry the HbS trait, 0.2% have the disease.

Front 17

Blood Dyscrasias-Sickle Cell Anemia: What can precipitate sickling?

Back 17

Low O2, dehydration.

Front 18

Blood Dyscrasias-Sickle Cell Anemia: What are the common complications of HbS homozygotes?

Back 18

aplastic crises from parvovirus infection, autosplenectomy, risk of encapsulated organism infection, salmonella osteomyelitis, vaso-occlusive pain crises, and splenic sequestration crises.

Front 19

Blood Dyscrasias-Sickle Cell Anemia: What is the HbC defect?

Back 19

Different Beta-chain mutation, the patients with HbC or HbSC have milder dz than HbSS patients.

Front 20

Blood Dyscrasias-Sickle Cell Anemia: What are the treatment options?

Back 20

Hydroxyurea (increased HbF) and bone marrow transplantation.

Front 21

Blood Dyscrasias-Alpha-Thalassemia: What populations have the most prevalence?

Back 21

Mediterranean populations. (thalaSEAmia)

Front 22

Blood Dyscrasias-Alpha-Thalassemia: What is the etiology?

Back 22

Underproduction of the alpha-globin chain, with no compensatory increase of any other chains. HbH has Beta-4 tetramers and lacks 3 alpha-globin genes.

Front 23

Blood Dyscrasias-Alpha-Thalassemia: What is the presentation of a patient lacking all four alpha-globin genes?

Back 23

hydrops fetalis and intrauterine fetal death.

Front 24

Blood Dyscrasias-Beta-Thalassemia: Patient Presentation of Beta-Thalassemia major?

Back 24

severe anemia requiring blood transfusion. Cardiac failure is often due to secondary hemochromatosis.

Front 25

Blood Dyscrasias-Beta-Thalassemia: Etiology of Beta-Thalassemia major?

Back 25

Beta chain is absent, fetal Hgb production is compensatorily increased but is inadequate.

Front 26

Blood Dyscrasias-Beta-Thalassemia: Etiology of Beta-thalassemia minor?

Back 26

The Beta chain is underproduced, again see fetal HgB compensatory increase. HbS/Beta-thalassemia heterozygote has mild to moderate disease.

Front 27

DIC: What is the definition of DIC?

Back 27

Activation of the coagulation cascade leading to microthrombi and global consumption of platelets, fibrin, and coagulation factors.

Front 28

DIC: What causes DIC?

Back 28

Obstetric complications (most common cause), gram-negative sepsis, transfusion, trauma, malignancy, acute pancreatitis, nephrotic syndrome.

Front 29

DIC: What are the lab findings in DIC?

Back 29

Increased PT, increased PTT, incrased fibrin split products (D-dimers), decreased platelet count.

Front 30

Bleeding Disorders: What disorder type presents with mucous membrane bleeding, petechiae, purpura, and prolonged bleeding time?

Back 30

Platelet abnormalities (microhemorrhages), which can be caused by ITP (antiplatelet antibodies and increased megakaryocytes), TTP (schistocytes), drugs, and DIC (increased fibrin split products).

Front 31

Bleeding Disorders: What disorder type presents with hemarthroses (bleeding into joints), easy brusing, prolonged PT and/or PTT?

Back 31

Coagulopathies (macrohemorrhages), which can be caused by Hemophilia A/B and von Willebrand's disease (most common)

Front 32

Bleeding Disorders: What is the deficiency in Hemophilia A?

Back 32

Factor VIII

Front 33

Bleeding Disorders: What is the deficiency in Hemophilia B?

Back 33

Factor IX

Front 34

Bleeding Disorders: What is the deficiency in vW dz?

Back 34

Deficiency of von Willebrand's antigen.

Front 35

Bleeding Disorders: Which factors does the PT measure?

Back 35

Extrinsic: Factors II, V, VII, and X.

Front 36

Bleeding Disorders: Which factors does the PTT measure?

Back 36

Intrinsic: All factors except VII and XIII.

Front 37

Hemorrhagic disorders: What presents with increased bleeding time, normal platelet count, and normal PT/PTT and platelet count?

Back 37

Qualitative platelet defects, can be Bernard Soulier disease (defect in adhesion) or Glanzmann's thrombasthenia (defect in aggregation). Can also see these labs in vascular bleeding.

Front 38

Hemorrhagic disorders: What presents with decreased platelet count, increased bleeding time, and normal PT/PTT?

Back 38

Thrombocytopenia

Front 39

Hemorrhagic disorders: Which diseases present with increased PTT and normal PT, platelet count, and bleeding time?

Back 39

Hemophilia A and B

Front 40

Hemorrhagic disorders: What presents with a high PTT, normal PT, normal platelets, and increased bleeding time?

Back 40

vW disease

Front 41

Hemorrhagic disorders: What presents with increased Bleeding time/Pt/PTT and decreased platelet count?

Back 41

DIC

Front 42

Lymphomas: Hodgkin's Versus NHL: Which one presents with Reed-Sternberg cells?

Back 42

Hodgkin's

Front 43

Lymphomas: Hodgkin's Versus NHL: Which one is associated with HIV and immunosuppression?

Back 43

NHL

Front 44

Lymphomas: Hodgkin's Versus NHL: Which one involves multiple, peripheral nodes, with common extranodal involvement?

Back 44

NHL

Front 45

Lymphomas: Hodgkin's Versus NHL: Which one is localized to a single group of nodes, with contiguous spread and rare extranodal involvement?

Back 45

HL

Front 46

Lymphomas: Hodgkin's Versus NHL: Which one presents with constitutional signs/symptoms: low-grade fever, night sweats, weight loss?

Back 46

HL (NHL has few signs/symptoms)

Front 47

Lymphomas: Hodgkin's Versus NHL: Which one presents with mediastinal lymphadenopathy?

Back 47

HL

Front 48

Lymphomas: Hodgkin's Versus NHL: Which one involves mostly the B cells (except lymphoblastic origin)?

Back 48

NHL

Front 49

Lymphomas: Hodgkin's Versus NHL: Which one has hypergammaglobulinemia?

Back 49

neither. Multiple Myeloma has hypergammaglobulinemia, where the excess B cells are in the resting state.

Front 50

Lymphomas: Hodgkin's Versus NHL: Which one has a 50% association with EBV?

Back 50

HL

Front 51

Lymphomas: Hodgkin's Versus NHL: Which one has bimodal age distribution?

Back 51

HL (NHL has peak incidence at 20-40 years old)

Front 52

Lymphomas: Hodgkin's Versus NHL: Which one has more common male presentation?

Back 52

HL

Front 53

Hodgkin's: What factors denote a good prognosis?

Back 53

Increased lymphocytes, decreased RS cells.

Front 54

Hodgkin's: Which HL type has the best prognosis?

Back 54

Nodular sclerosing (65-75%), which has least RS cells and lots of lymphocytes. Lymphocyte-predominant LH also has excellent prognosis.

Front 55

Hodgkin's: Which HL type is the most common?

Back 55

Nodular sclerosing, affecting women more than men and primarily young adults.

Front 56

Hodgkin's: What is the prognosis of mixed cellular HL?

Back 56

Intermediate. There are lots of lymphocytes but also lots of RS cells.

Front 57

Hodgkin's: Which HL type has the worst prognosis?

Back 57

Lymphocyte-depleted, which affects older males with disseminated disease.

Front 58

Hodgkin's: Which HL type has the most RS cells?

Back 58

Mixed cellular.

Front 59

NHL: Which NHL type has only B cells?

Back 59

Small Lymphocytic lymphoma, follicular lymphoma, Burkitt's

Front 60

NHL: Which NHL type has a mix of B cells and T cells?

Back 60

Diffuse large cell , occurring mostly in elderly but sometimes in children.

Front 61

NHL: Which NHL type has only T cells?

Back 61

Lymphoblastic Lymphoma, which has immature T cells. It is a very aggressive T-cell lymphoma.

Front 62

NHL: Which type is associated with a t(8;14) c-myc gene mutation?

Back 62

Burkitt's Lymphoma, occurring mostly in children. Has a high-grade "starry sky" apearance.

Front 63

NHL: Which type is associated with a t(14;18) mutation and overexpression of bcl-2?

Back 63

Follicular lymphoma, which is difficult to cure but has an indolent course.

Front 64

NHL: Which type is associated with EBV infection and is endemic in africa?

Back 64

Burkitt's

Front 65

NHL: Which is the most common childhood NHL?

Back 65

Lymphoblastic Lymphoma, which also presents with ALL and a mediastinal mass.

Front 66

NHL: Which is the most common adult version of NHL?

Back 66

Follicular lymphoma.

Front 67

NHL: Which types occur in adults?

Back 67

Small lymphocytic lymphoma, follicular lymphoma.

Front 68

NHL: Which types occur in children?

Back 68

Lymphoblastic lymphoma, Burkitt's lymphoma.

Front 69

NHL: Which one has a distribution of 80% adults and 20% children?

Back 69

Diffuse large cell lymphoma, which ALSO has an 80% B cells 20% T cell distribution.

Front 70

NHL: Which low-grade NHL type presents like CLL?

Back 70

Small Lymphocytic lymphoma.

Front 71

NHL: AUTHOR

Back 71

John Peoples

Front 72

Leukemias: Peripheral and bone marrow characteristics

Back 72

Increased circulating leukocytes, bone marrow infiltrates of leukemic cells

Front 73

Leukemias: Consequences of marrrow failure

Back 73

Anemia (dec. RBC's), infections (dec. WBC's), hemorrhage (dec. platelets)

Front 74

Leukemias: Common organs of infiltration

Back 74

Liver, spleen, lymph nodes

Front 75

Leukemias: Characteristics of acute leukemias

Back 75

Blasts predominate, children or elderly, short or drastic course

Front 76

Leukemias: ALL characteristics (4)

Back 76

Lympholasts (pre-B or pre-T), children, most responsive to therapy, associated with Down's Syndrome

Front 77

Leukemias: AML characteristics

Back 77

Myeloblasts, adults, auer rods

Front 78

Leukemias: Characteristics of chronic leukemias

Back 78

More mature cells, midlife age range, longer, less devastating course

Front 79

Leukemias: CLL characteristics - cells

Back 79

Lymphocytes, non-Ab producing B cells, increased smudge cells on peripheral blood smear

Front 80

Leukemias: CLL - population

Back 80

older adults

Front 81

Leukemias: CLL - presentation and course

Back 81

lymphadenopathy, hepatosplenomegaly, few sx., indolent course

Front 82

Leukemias: CLL is similar to?

Back 82

very similar to SLL (small lymphocytic lymphoma)

Front 83

Leukemias: CLL is associated with what type of anemia?

Back 83

warm antibody autoimmune hemolytic anemia

Front 84

Leukemias: CML cell characteristics

Back 84

Myeloid stem cells, increased neutrophils and metamyelocytes

Front 85

Leukemias: CML translocation?

Back 85

Ph Chromosome, t(9;22), bcr-abl

Front 86

Leukemias: CML acute complications?

Back 86

blast crisis (AML)

Front 87

Chromosomal translocations - the following disorder is associated with what translocation?: CML

Back 87

Ph chromosome, t(9;22), bcr-abl

Front 88

Chromosomal translocations - the following disorder is associated with what translocation?: Burkitt's lymphoma

Back 88

t(8;14), c-myc activation

Front 89

Chromosomal translocations - the following disorder is associated with what translocation?: Follicular lymphomas

Back 89

t(14;18), bcl-2 activation

Front 90

Chromosomal translocations - the following disorder is associated with what translocation?: AML- M3 type

Back 90

t(15;17), responsive to all-trans retinoic acid (ATRA)

Front 91

Chromosomal translocations - the following disorder is associated with what translocation?: Ewing's sarcoma

Back 91

t(11;22)

Front 92

Chromosomal translocations - the following disorder is associated with what translocation?: Mantle cell lymphoma

Back 92

t(11;14)

Front 93

Lymphomas and Leukemias: What are the chronic leukemias associated with T-lymphoblasts?

Back 93

Sezary Syndrome, CLL-T (both L2)

Front 94

Lymphomas and Leukemias: What are the acute leukemias associated with T-lymphoblasts?

Back 94

ALL-T (L2), ALL-null (L1), ALL-common(L1)

Front 95

Lymphomas and Leukemias: What are the chronic leukemias associated with B-lymphoblasts?

Back 95

CLL-B (L3)

Front 96

Lymphomas and Leukemias: What are the acute leukemias associated with B-lymphoblasts?

Back 96

ALL-B (L3)

Front 97

Lymphomas and Leukemias: What are the chronic leukemias associated with monoblasts?

Back 97

Chonic monocytic (M5), chronic myelomonocytic (M4)

Front 98

Lymphomas and Leukemias: What are the acute leukemias associated with monoblasts?

Back 98

Acute monocytic (M5), acute myelomonocytic (M5)

Front 99

Lymphomas and Leukemias: What are the chronic leukemias associated with myeloblasts?

Back 99

CML (M1, 2 and 3), Polycythemia rubra vera (M1), myelofibrosis (M1)

Front 100

Lymphomas and Leukemias: What are the acute leukemias associated with myeloblasts?

Back 100

AML (M2 and M1), Promyelocytic (M1)

Front 101

Lymphomas and Leukemias: What are the chronic leukemias associated with eos-myeloblasts?

Back 101

Eosinophilic (rare)

Front 102

Lymphomas and Leukemias: What are the chronic leukemias associated with normoblasts?

Back 102

Chronic erythroid (M6, rare)

Front 103

Lymphomas and Leukemias: What are the acute leukemias associated with normoblasts?

Back 103

acute erythroleukemia (M6)

Front 104

Lymphomas and Leukemias: What are the chronic leukemias associated with megakaryoblasts?

Back 104

Idiopathic thrombocytopenia (M7)

Front 105

Lymphomas and Leukemias: What are the acute leukemias associated wwith megakaryoblasts?

Back 105

acute megakaryocytic leukemias (M7)

Front 106

Multiple Myeloma: What type of cell proliferates in MM, and what is its histologic appearance

Back 106

Monoclonal plasma cell, fried egg apearance

Front 107

Multiple Myeloma: Where does MM arise?

Back 107

bone marrow

Front 108

Multiple Myeloma: The 2 most common ab's, in order, are:

Back 108

IgG (55%), IgA (25%)

Front 109

Multiple Myeloma: Common symptoms are:

Back 109

lytic bone lesions and hypercalcemia, renal insifficiency, increased suscpetibility to infection, anemia

Front 110

Multiple Myeloma: This disease is associated with:

Back 110

primary amyloidosis

Front 111

Multiple Myeloma: Ig light chains are also called:

Back 111

Bence Jones proteins

Front 112

Multiple Myeloma: 3 key diagnostic features:

Back 112

lytic bone lesions on x-ray, M-spike on serum protein electrophoresis, Bence-Jones proteins in urine

Front 113

Multiple Myeloma: Red blood cell appearance on peripheral smear:

Back 113

Rouleaux formation (poker chips)

Front 114

Multiple Myeloma: What 2 differences are seen in Waldenstrom's macroglobulinemia?

Back 114

M-spike is IgM, no lytic lesions

Front 115

Blood composition: Plasma-clotting factors = what?

Back 115

serum

Front 116

Blood composition: Blood is ___% of body weight

Back 116

0.08

Front 117

Blood composition: Blood is ___% plasma.

Back 117

55% The rest is formed elements (hematocrit)

Front 118

Blood composition: Plasma is ____% proteins.

Back 118

0.07

Front 119

Blood composition: Plasma proteins are ___% albumin.

Back 119

0.55

Front 120

Blood composition: Plasma proteins are ___% globulins

Back 120

0.38

Front 121

Blood composition: Leukocytes are normally ____% PMNs, ___% lymphocytes, ___% monocytes, ___% eosinophils, ___basophils.

Back 121

40-70% PMNs, 20-40% lymphos, 2-10% monos, 1-6% eos, <1% basophils

Front 122

Blood composition: AUTHOR

Back 122

Chris Leander

Front 123

Coagulation Cascade: Factor initiating intrinsic pathway?

Back 123

XII

Front 124

Coagulation Cascade: Factor(s) initiating extrinsic pathway?

Back 124

VII and tissue factor

Front 125

Coagulation Cascade: Function of factor XIII?

Back 125

Forms cross-linked fibrin

Front 126

Coagulation Cascade: Factors examined with prothrombin time (PT)?

Back 126

VII, X, V, prothrombin, fibrinogen (Hoffbrand. Haematology. 247)

Front 127

Coagulation Cascade: Factors examined with partial thromboplastin time (PTT)?

Back 127

VIII, IX, XI, XII, X, V, prothrombin, fibrinogen (Hoffbrand. Haematology. 247)

Front 128

Coagulation Cascade: Vitamin K dependent factors?

Back 128

II, VII, IX, X, protein C, protein S (243)

Front 129

Coagulation Cascade: Factors requiring phospholipid surface for activation?

Back 129

IX and X

Front 130

Coagulation Cascade: Factor I also known as?

Back 130

Fibrinogen

Front 131

Coagulation Cascade: Factor II also know as?

Back 131

Prothrombin

Front 132

Convergence of coagulation, complement, and kinin pathways: Two substrates of Factor XIIa?

Back 132

Factor XI and Prekallikrein

Front 133

Convergence of coagulation, complement, and kinin pathways: Components involved in the activation of factor XII?

Back 133

Collagen, basement membrane, activated platelets, HMWK (cofactor [high molecular weight kallikrein])

Front 134

Convergence of coagulation, complement, and kinin pathways: Two substrates of kallikrein?

Back 134

HMWK and Plasminogen

Front 135

Convergence of coagulation, complement, and kinin pathways: Complement protein on which plasminogen acts?

Back 135

C3

Front 136

Convergence of coagulation, complement, and kinin pathways: Three functions of bradykinin?

Back 136

Increase vasodilation, increase permeability, increase pain

Front 137

Convergence of coagulation, complement, and kinin pathways: What converts HMWK to bradykinin?

Back 137

kallikrein

Front 138

Convergence of coagulation, complement, and kinin pathways: What does plasmin's action on fibrin produce?

Back 138

fibrin split products