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77 Cards in this Set

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the process that determines the formation and development of the wide variety of cellular elements of the blood?
where is the principal site inutero for the siteof erythropoiesis?
the spleen. after 6 weeks of gestation
where is the definitive long-term site for hematopoiesis?
the bone marrow
in an adult, where does active bone marrow reside?
in axial skeleton: (sternum, vertebrae, pelvis and ribs), and in the proximal end of humerous and femur.
what are some examples of myeloproliferative disorders?
A group of disease states which primarily involve the bone marrow and the production blood cells.
EX: polycythaemia vera, leukemia, myelofibrosis and primary thrombocytopenia.
NON-antibody proteins secreted by inflammatory leukocytes and some non-leukocytic cells, that act as intercellular mediators. They differ from classical hormones in that they are produced by a number of tissue or cell types rather than by specialized glands. They generally act locally in a paracrine or autocrine rather than endocrine manner.
this cytokine is produced by the kidney in response to hypoxia/anemia, it stimulates proliferation and maturation of RBC progenitors
this cytokine stimulates proliferation and maturation of granulocytes, increases release of stem cells in peripheral blood,
G-CSF. Granulocyte-Colony stimulating factor
proliferation of megakaryocytes
this cytokine causes a proliferation of T cells
this cytokine causes a proliferation of B cells
what is the MC etiology of microcitic anemia?
colon carcinoma-esp if older. (chron's, UC) Colonoscopy to DX
patient presents with numbness in fee, icterius, colitis, mild confusion, 2/6 systolic murmur, propoceptive loss: HBg 9.0, WBC 3.1k PLT: 45k. what is the most likely DX?
aplastic anemia. pancytopenia = aplastic
B12 deficiency could explain the neurological findings.
what are some common LAB findings of macrocytic anemias?
increased MCV
decreased B12
decreased Folate
hypersegmented neutrophils
what is the MC cause of microcytic anemia?
iron deficiency
which of the anemias is associated with E.coli 0157:H7?
hemolytic anemia
what is the only type of hematological malignancy that produces an adenoma?
normal range for Hbg?
women: 12-16 g/dL
men: 13.5-17.5 g/dL
what is normal range for HCT?
women 36-46%
men 41-53%
normal reticulocyte range?
.5 - 1.5%
MCV normal range?
normal PLT range?
normal WBC count/range
normal neutrophil range?
1800-7700/uL 60%
normal Lymphocyte range?
1000-4800/uL 35%
normal monocyte count?
300uL <5%
a disorder of hematopoiesis that results in disruption of stem cell development and can result in the underproduction of mature progeny?
aplastic anemia
a disorder of hematopoiesis that results in disruption of stem cell development and can result in the overproduction of mature progeny?
myeloproliferative disease
a disorder of hematopoiesis that results in disruption of stem cell development failed differentiation with production of too many immature forms?
myelodysplasia and acute leukemia
first described by paul ehrlich, a failure of hematopoietic stem cell production, characterized by pancytopenia with a markedly hypocellular bone marrow?
aplastic anemia
patients labs return as follows:
Neutrophil: <500/uL
PLT: <20,000/uL
Bone Marrow: cellularity <25%
what is the most likely dx?
aplastic anemia
what are some etiologies of aplastic anemia?
chemotherapeutic agents, ABX, NSAIDs, anticonvulsants, GOLD, Hep, Epstein Barr, HIV, Radiation
what are considered to be the macrophages of the brain?
microglial cells
what are the macrophage cells of the liver?
kupfer cells
on CBC w/ diff, you see a Left Shift?
bacterial infection, increase in (immature) neutrophils=BANDS
on CBC w/ Diff you notice a R shift?
viral infection.
a disorder that is characterized by ineffective and disordered hematopoiesis in one or more of the major myeloid cell lines. Accompanied by increased apoptosis which contributes to the decreased release of mature cells into the periph.
myelodysplastic disorders
what might you see in a differential smear of a p with a myelodysplastic disorder?
cytopenias, erythroid cells are macrocytic, w/ basophilic sti;;ling. Neutrophils are hypogranular and hypolobulated w/ characteristic bilobed nuclear morphology (pseudo-Pelger-Huet anolmaly)
a characteristic bilobed nuclear morphology of neutrophils; should be suspected when automated differential cell counts report an unusually large number of bands`
pseudo-Pelger-Huet anomaly. indicitive of myelodysplastic disorders.
these disorders are clonal stem cell disorders characterized by leukocytosis, thrombocytosis, erythrocytosis, splenomegaly and bone marrow hypercellularity.
myeloproliferative disorders
a rare chronic blood disorder characterized by the overproduction of platelets by the bone marrow in the absence of an alternative cause. In some cases this disorder may be progressive, and rarely may evolve into acute myeloid leukemia or myelofibrosis.
essential thrombocytosis "the million dollar PLT"
a primary stem cell disorder characterized by an increased circulating red blood cell mass.
polycythemia vera. increased cells in the blood.
if a patient with PV is left untreated, they will suffer significant morb/mort. from what type of hematopoietic disease?
thromboembolic disease in the cerebral, coronary and mesenteric circulations.
what are some of the common complaint from a patient with PV?
headache, visual problems, mental clouding, pruritus after bathing, stroke, TIA, MI.
Digital pain, parestesias and gangrene are common. DVT's may occur
patient presents to you with complaints of evidence of GI bleeding. upon PE you palpate splenomegaly, and observe retinal vein occlusion. Labs return with Decreased MCV, mild Fe deficiency. Bone marrow exam shows a hypercellular marrow. what is the most likely dx?
polychthemia vera
what are some risk factors for patients c polycythemia vera to vascular events?
advanced age, prior H/O thrombosis, elevated Hematocrit values
a pluripotent stem cell disorder resulting in elevated levels of PLT's and WBC's?
essential thrombocytosis
what is the typical CBC presentation for p with ET?
PLT >600,000
RCM: normal
FE studies: normal
bone marrow: normal and excluding myelodysplasia, myelofibrosis & Philadelphia chromosome.
what is Philadelphia chromosome indicitive of?
what are some symptoms for p with essential thrombocytosis?
HA, dizziness, visual changes, erythromelalgia (burning pain in hands/feet)
what is the most common first line agent used to lower PLT and WBC counts?
hydroxyurea. a nonspecific myelosuppressive agent.
a clonal stem cell disorder characterized by abnormal excess marrow fibrosis leading to marrow failure?
a process that occurs in myelofibrosis where the premature multipotent hematopoietic precursors migrate and reestablish themselves in other sites, thereby shifting hematopoiesis out of the marrow and into (spleen, liver)?
extramedullary hematopoiesis
which disorder will typically cause the "teardrop" presentation of RBC on a differential?
myelofibrosis aka agnogenic myeloid metaplasia
what are the chief complaints of patients c myelofibrosis?
progressive fatigue, dyspnea related to anemia or early satiety and LUQ fullness, or pain due to splenomegaly
anemia, splenomegaly, evidence of extramedullary hematopoiesis, bone marrow fibrosis with normal RCM and lack of philadelphia chromosome is indicitive of what DX?
an MPD characterized by a predominantly increased granulocytic cell line associated with concurrent erythroid and PLT hyperplasia?
chronic myelogenous leukemia
a profound leukocytosis (values of WBC > 35,000) may be indicitive to?
the development of some kind of leukemia. AML, CML.
(aka a leudomoid reaction)
what is the symptomotology for anemia?
Bruise easily
a nail disease that can be an indication of iron deficiency, "spoon nails", which are concave.
what is the symptomotology for thrombocytopenia?
occult blood, bleeding gums, purpura, echymosis, epistaxis, petechiae
what are 4 common etiologies for anemia?
Bleeding (menses, fe def.)
Impaired production
what does the term acitinic refer to?
age spots and sun spots on light skin
a patient presents with dehydration and other symptoms indicitive of a reactive polycythemia. You give O2, and IV fluids, but there is no signs of rehydration? what is a probable cause of this?
hyperviscosity syndrome. blood is so viscous, that it is not able to get to important tissues.
Triangular helmet shaped cells found in blood, usually indicative of disorders of small blood vessels.
burr cells
A red blood cell that exhibits a slit or mouth-shaped pallor rather than a central one on air-dried smears; e.g., Rh null cells.
a factor VIII deficiency is known as ?
hemophilia A
a factor IX deficiency is known as?
hemophilia B
what physical manifestations stem from a B12 deficiency?
parestesias, dementia, confabulation
what are some etiologies of a B12 deficiency?
alcohol, hypothyroidism, drugs (anti-retro virals), anti-neoplastics (sulfonamides)
what is the job of haptoglobin?
it binds hemoglobin and transports it back to the liver
what are some common etiologies for microcytic anemias?
iron deficiency, thalassemias (alpha/beta) sickle cell, anemia of chronic dz.
what are some common etiologies for normalcytic anemias?
aplastic anemia, anemia of chronic dz, chronic renal failure
what is the most common MPD?
chronic myelogenous leukemia
in the early stages of this disease, patients are asymptomatic. They can have fatigue, lethargy, SOB, weight loss, easy bruising and early satiety. Splenomegaly. WBC >170k , + elevated uric acid and lactate dehydrogenase + thrombocytosis.
what treatment has been heralded as the first successful targeted therapy for CML?
Gleevac. formerly STI-571
what are some known risk factors for leukemia?
high dose radiation exposure, occupational exposure to benzene