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31 Cards in this Set

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  • Back
when do you see basophilic stippling?
TAIL
- Thalassemia
- Anemia of chronic disease
- Iron deficeincy anemia
- Lead poisoning
cells of varying sizes
anisocytosis
cells of varying shapes
poikilocytosis
cromolyn sodium
- prevents mast cell degranulation
- used to treat asthma
list the causes of eosinophilia
NAACP
- Neoplastic
- Asthma
- Allergic process
- Collagen vascular disease
- Parasites
when do you see hypersegmented polys?
- vit B12/folate deficiency
- unlike
describe a plasma cell
- off center nucleus
- clock face chromatin
- abundant RER and well developed golgi apparatus
- Multiple myeloma is a plasma cell neoplasm
what do Protein C and protein S do?
- inactivate 5a and 8a
- vit K dependent
- Factor V Leiden mutation causes resitance to activated protein C
what does antithrombin III do?
- inactivates thrombin, 9a, 10a, and 11a
- activated by heparin
what does tPa do?
- generates plasmin, which cleaves fibrin
what causes spherocytes?
- hereditary spherocytosis
- autoimmune hemolysis
what causes elliptocytes?
- hereditary elliptocytosis
what causes macro-ovalocytes?
- megaloblastic anemia (also, hypersegmented PMNs)
- marrow failure
what causes helmet cell/schistocytes?
- DIC
- traumatic hemolysis
what causes teardrop shaped cells?
- myeloid metaplasia with myelofibrosis
what causes acanthocytes?
- spiny appearance in abetalipoproteinemia
- aka 'spur cell'
what causes target cells?
HALT
- HbC disease
- Asplenia
- Liver disease
- Thalassemia
what causes poikilocytes
- different shapes
- TTP/HUS
- microvascular damage
- DIC
what causes Burr cells?
- TTP/HUS
what are Psammoma bodies?
- laminated, concentric, calcific spherules seen in:
1. Papillary adenocarcinoma of thyroid
2. Serous papillary cystadenocarcinoma of ovary
3. Meningioma
4. Malignant mesothelioma
microcytic anemias (MCV <80)
- Iron deficiency (↓ serum iron, ↑ TIBC, ↓ ferritin)
- thalassemia
- Lead poisoning
macrocytic anemias (MCV >100)
- megaloblastic (vit B12/folate deficiency)
- drugs that block DNA synthesis (sulfa, AZT)
- marked reticulocytosis
what is the clinical difference between vit B12 and folate deficiency?
- vit B12 (e.g. pernicious anemia) is associated with neurologic problems
normocytic, normochromic anemias
- 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)
how do you test for RBC hemolysis?
↓ serum haptoglobin
↑ serum LDH
- use the Direct Coombs test to distinguish between immune vs non-immune RBC hemolysis
Aplastic anemia
- 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
how do you treat aplastic anemia?
- withdrawal of offending agent
- allogenic BM transplant
- RBC and platelet transfusion
- G-CSF or GM-CSF
what are some complications of sickle cell anemia?
- aplastic crisis (due to parvovirus B19 infection)
- autosplenectomy
- ↑ risk of encapsulated organism infection
- salmonella osteomyelitis
- painful crisis
- splenic separation crisis
how do you treat sickle cell anemia?
- hydroxyurea, which increases HbF
- BM transplant
alpha- thalassemia
- 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
beta-thalassemia
- 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