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31 Cards in this Set
- Front
- Back
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when do you see basophilic stippling?
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TAIL
- Thalassemia - Anemia of chronic disease - Iron deficeincy anemia - Lead poisoning |
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cells of varying sizes
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anisocytosis
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cells of varying shapes
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poikilocytosis
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cromolyn sodium
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- prevents mast cell degranulation
- used to treat asthma |
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list the causes of eosinophilia
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NAACP
- Neoplastic - Asthma - Allergic process - Collagen vascular disease - Parasites |
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when do you see hypersegmented polys?
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- vit B12/folate deficiency
- unlike |
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describe a plasma cell
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- off center nucleus
- clock face chromatin - abundant RER and well developed golgi apparatus - Multiple myeloma is a plasma cell neoplasm |
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what do Protein C and protein S do?
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- inactivate 5a and 8a
- vit K dependent - Factor V Leiden mutation causes resitance to activated protein C |
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what does antithrombin III do?
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- inactivates thrombin, 9a, 10a, and 11a
- activated by heparin |
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what does tPa do?
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- generates plasmin, which cleaves fibrin
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what causes spherocytes?
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- hereditary spherocytosis
- autoimmune hemolysis |
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what causes elliptocytes?
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- hereditary elliptocytosis
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what causes macro-ovalocytes?
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- megaloblastic anemia (also, hypersegmented PMNs)
- marrow failure |
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what causes helmet cell/schistocytes?
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- DIC
- traumatic hemolysis |
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what causes teardrop shaped cells?
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- myeloid metaplasia with myelofibrosis
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what causes acanthocytes?
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- spiny appearance in abetalipoproteinemia
- aka 'spur cell' |
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what causes target cells?
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HALT
- HbC disease - Asplenia - Liver disease - Thalassemia |
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what causes poikilocytes
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- different shapes
- TTP/HUS - microvascular damage - DIC |
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what causes Burr cells?
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- TTP/HUS
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what are Psammoma bodies?
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- laminated, concentric, calcific spherules seen in:
1. Papillary adenocarcinoma of thyroid 2. Serous papillary cystadenocarcinoma of ovary 3. Meningioma 4. Malignant mesothelioma |
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microcytic anemias (MCV <80)
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- Iron deficiency (↓ serum iron, ↑ TIBC, ↓ ferritin)
- thalassemia - Lead poisoning |
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macrocytic anemias (MCV >100)
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- megaloblastic (vit B12/folate deficiency)
- drugs that block DNA synthesis (sulfa, AZT) - marked reticulocytosis |
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what is the clinical difference between vit B12 and folate deficiency?
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- vit B12 (e.g. pernicious anemia) is associated with neurologic problems
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normocytic, normochromic anemias
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- acute hemorrhage
- G6PD - PK deficiency - hereditary spherocytosis - aplastic anemia - leukemia - sickle cell disease - autoimmune hemolytic anemia - anemia of chronic disease (↓ TIBC, ↑ ferritin, ↑ storage iron in marrow macrophages) |
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how do you test for RBC hemolysis?
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↓ serum haptoglobin
↑ serum LDH - use the Direct Coombs test to distinguish between immune vs non-immune RBC hemolysis |
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Aplastic anemia
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- pancytopenia caused by failure or destruction of myeloid stem cells
- caused by radiation, benzene, chloramphenicol, alkylaing agents, antimetabolites, parvovirus, EBV, HIV, Fanconi's anemia, idiopathic, acute hepatitis - symptoms: fatigue, petechia - hypocellular BM with fatty replacement |
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how do you treat aplastic anemia?
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- withdrawal of offending agent
- allogenic BM transplant - RBC and platelet transfusion - G-CSF or GM-CSF |
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what are some complications of sickle cell anemia?
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- aplastic crisis (due to parvovirus B19 infection)
- autosplenectomy - ↑ risk of encapsulated organism infection - salmonella osteomyelitis - painful crisis - splenic separation crisis |
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how do you treat sickle cell anemia?
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- hydroxyurea, which increases HbF
- BM transplant |
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alpha- thalassemia
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- a-globin chain is underproduced
- HbH (B4-tetramers, lacks 3 a-globin genes) - Hb Barts (gamma4-tetramers, lacks all 4 a globin genes) -> hydrops fetalis and death |
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beta-thalassemia
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- beta chain is underproduced
- fretal Hb production is compensatorily increased, but inadequate - requires blood transfusions - cardiac failure due to seconary hemochromatosis - marrow expansion -> skeletal deformities |
