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52 Cards in this Set

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Microcytic Anemias
iron deficiency
ACD
Thals
Sidero (lead poisoning)
Macrocytic anemias
Folate and B12 defs
Normocytic anemias w/ low corrected reticulocyte count
blood loss < 1 week
early stage iron def
early stage ACD
Aplastic Anemia
Renal disease
Malinancy
Normocytic anemia w/ corrected reticulocyte count > 3 percent
INTRINSIC DEFECTS
Membrane defects (sphero, ellipto, PNH)
Abnormal hemoglobins (sickle cell)
Deficient Enzymes (PK Def, G6PD def.)

EXTRINSIC DEFECTS
Blood loss > 1 week
Immune Hemolytic Anemias
Micro/Macroangioathic Hemolytic Anemias
Malaria
Labs of Iron def Anemia
Serum Fe: LOW
TIBC: HIGH
Percent Sat: LOW
Serum Ferritin LOW
Others: increased RDW
Labs of ACD
Serum Fe: LOW
TIBC: LOW
Percent Sat: LOW
Serum Ferritin: HIGH
Others: none
Labs of Thalassemias
Serum Fe: NORMAL
TIBC: NORMAL
Percent Sat: NORMAL
Serum Ferritin: NORMAL
Others: increased RBC count, Hb electrophoresis normal in alpha thal, abnormal in beta thal
Labs of Lead poisoning Anemia (a micro
Serum Fe: HIGH
TIBC: LOW
Percent Sat: HIGH
Serum Ferritin: HIGH
Others: Ringed sideroblasts and coarse basophilic stipling
Polycythemia vera Labs
RBC mass: HIGH
Plasma volume: HIGH
SaO2: NORMAL
EPO: LOW
Appropriate polycythemia (COPD, Cyanotic Congenital heart disease)
RBC mass: HIGH
Plasma volume: NORMAL
SaO2: LOW
EPO: HIGH
Inappropriate polycythemia labs (ectopic EPO (eg. RCC))
RBC mass: HIGH
Plasma volume: NORMAL
SaO2: NORMAL
EPO: HIGH
Relative Polycythemia (eg. volume depletion) Labs
RBC mass: NORMAL
Plasma volume: LOW
SaO2: NORMAL
EPO: NORMAL
MC AML; Auer Rods; 15-59 yo
M2 AML with maturation
Numerous auer rods; DIC invariable; t(15;17); remission induced by retinoic acid
M3: Acute Promyelocytic
No auer rods; gum infiltration
M5 Acute Monocytic
Erythtoblasts, myeloblasts
M6 Acute erythroleukemia
Myelofibrosis; associated with down syndrome
M7 Acute Megakaryocytic
Children (nb - 14 yo)
CALLA (CD10) and TdT positive
t(12;21)
normocytic anemia, thrombocytopenia
CNS and Testicular Mets
ALL (early Bcell type)
Children (nb - 14 yo)
CALLA (CD10) negative
TdT positive
t(12;21)
normocytic anemia, thrombocytopenia
Mets to mediastinum
ALL (Tcell)
virgin B cells (hypogammaglobulinemia)
patients > 60 yo
generalized lymphadenopathy
smudge cells, thrombocytopenia, anemia (immune hemolytic)
CLL
HTLV-1 association
CD4 positive
TdT negative
Skin infiltrate
Lytic bone lesions with hypercalcemia
Adult T-Cell leukemia
B cell leukemia
TRAP stain positive
response to purine nucleosides
cytoplasmic projections
Hairy cell leukemia
EBV associated NHL
t(8;14)
starry sky
GI ract, para-aortic nodes (american)
jaw (african)
Bone marrow involvement
Burkitt's lymphoma
Common adult NHL
germinal centers
extranodal involvement (GI, brain (ebv assoc.))
Diffuse Large Bcall lymphoma
H. pylori associated
MALT derived
stomach
Extranodal Marginal lymphoma
common adult NHL, elderly patients
germinal center
t(14;18) BCL2
Generalized lymphadenopathy
BM involvement
Follicular lymphoma
elderly patients
small mature B cells
generalised lymphadenopathy
SLL (lymphoma)/CLL (leukemic)
t(11;14)
BCL1/Cyclin D activation
Mantle Cell lymphoma
asymptomatic young males w/ cervical/supraclavicular lymphadenopathy
L/H variants of RS cells (popcorn cells)
Lymphocyte Predominant Hodgkins
Anterior mediastinal nods (CXR) AND either cervical or mediastinal nodes
Lacunar variant RS cells
Collagen (via TGFb) seperates malignant areas
sixty percent of hl, mostly female
Nodular sclerosing HL
RS cells numerous; mononuclear variants
eosinophils (IL5), plasmacells, histiocytes
men over 50
epstein barr associated
common
mixed cellularity HL
RS cells frequent
most aggressive
men over 50
rare
lymphocyte depletion HL
DIFFUSE Eczematous rash
Organ involvement
Lytic lesions of bones
Rapidly Fatal
CD1 positive
Birbeck granules
Letterer Siwe Langerhans Histiocytosis
Fever
LOCALIZED rash (scalp, ear canal)
lytic skul lesions
DI due to post.pit invasion
exophthalmos
CD1 positive
Birbeck granules
Hand Schuller Christian Langerhans Histiocytosis
Unifocal lytic lesion
CD1 positive
Birbeck granules
eosinophilic granulomas lngerhans histiocytosis
platelet aggregation defect
AR
Absent GpIIb/IIIa receptors
absent thrombosthenin
Glanzmanns disease
Platelet adhesion defect
AR
Absent GpIb receptors for vWF
giant platelets w/thrombocytopenia
Bernard Soulier
vascular defect
caused by vitamin C def.
defective collagen resulting in poor crosslinking
ecchymoses and hemarthrosis
Scurvy
platelet adhesion defects
AD
absent vWF (thus decreased VIII:c)
combinedplatelet and coagulation factor disorder
vWD
IgG antibodies against GpII/III receptors (T2HSR)
post-viral infection
epistaxis bruising, petechiae
children
Acute ITP
IgG antibodies against GpII/III receptors (T2HSR)
SLE, HIV, Lymphoprliferative disorders
splenectomy, IV y-globulin
Adults (women esp)
Chronic ITP
deficiency of vWF-cleaving metalloprotease in endothelial cells
increased circulating vWF multimers increases platelet adhesion to areas of endothelial injury at arteriole-capillary junctions
platelets consumed by thrombi production (not DIC)
TTP
PENTAD: FEVER, THROMBOCYTOPENIA, RENAL FAILURE, SCHISTOCYTES (MHA), CNS DEFECITS
TTP
endothelial damage from shigalike toxin of 0157H7 E coli (undercooked beef) (also, shigella and salmonella)
HUS
QUARTAD: THROMBOCYTOPENIA, RENAL FAILURE, SCHISTOCYTES (MHA), BLOODY DIARRHEA
HUS
Thrombocytopenia, ITP, TTP, HUS
Labs (platelet count, BT, PT, PTT)
PC: LOW
BT: HIGH
PT: NORMAL
PTT: NORMAL
vWD Labs (platelet count, BT, PT, PTT)
PC: NORMAL
BT: HIGH
PT: NORMAL
PTT: HIGH (factor 8c)
Hemophilia
Labs (platelet count, BT, PT, PTT)
PC: NORMAL
BT: NORMAL
PT: NORMAL
PTT: HIGH
DIC
Labs (platelet count, BT, PT, PTT)
PC: low
BT: high
PT: high
PTT: high
Primary firbinolysis
Labs (platelet count, BT, PT, PTT)
PC: normal
BT: high
PT: high
PTT: high
aspirin/nsaids
Labs (platelet count, BT, PT, PTT)
PC: normal
BT: high
PT: normal
PTT: normal
warfarin/heparin
Labs (platelet count, BT, PT, PTT)
PC: normal
BT: normal
PT: high
PTT: high