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30 Cards in this Set
- Front
- Back
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Name five causes of microcytic hypochromic anemia
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Iron-deficiency, thalassemia (alpha or beta), lead poisoning, sideroblastic anemia, anemia of chronic disease (uncommon)
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Name three common causes of Fe-deficiency anemia
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Heavy menstruation, GI bleeding (NSAID use, ulcers, GI malignancy), low intake, malabsorption (celiac)
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Which virus is associated with aplastic crisis in sickle cell and other hemolytic anemias such as hereditary spherocytosis
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parvovirus B19
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Name three causes of macrocytosis
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Megaloblastic anemia (B12 or folate deficiency), folate antagonist drugs (sulfa drugs, trimethoprim, MTX), alcohol use (causing macrocytosis but not necessarily anemia)
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What Ig subtypes are involve in
a) warm and b) cold agglutinin autoimmune hemolytic anemia |
a) IgG
b) IgM |
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Where does a) warm and b) cold agglutinin hemolytic anemia take place (intra- or extravascular)
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a) warm takes place in spleen and liver(extravascular) - peices of membrane bound to IgG nicked off as pass through, altering shape, and inducing hemolysis
b) intravascular - IgM can bridge RBCs negative charges |
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Which diseases are associated with cold agglutinins
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Mycoplasma pneumonia and infectious mononucleosis
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Which diseases are associated with warm agglutinins
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SLE, CLL, multiple myeloma
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Autoimmune hemolytic anemias produce which result on
a) Direct Coombs test b) Indirect Coombs test |
a) positive - adding anti-Ig ab to pts RBCs induces agglutination if coated in Ig
b) positive - adding pts serum to normal RBCs will agglutinate them if anti-RBC Ig present |
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What supplement should be considered in hemolytic anemia?
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B12 - increased erythropoiesis puts greater demands on B12 stores
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What is the defect in paroxysmal nocturnal hemoglobinuria?
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Defect in gene PIGA leading to deficient synthesis of GPI anchors - membrane proteins such as Decay accelerating factor are not anchored by GPI and cannot protect from complement mediated lysis
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Where is the defect in hereditary spherocytosis?
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Defects in a cytoskeletal protein; either spectrin, or less commonly ankyrin
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What type of hemolysis occurs in hereditary spherocytosis
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Extravascular - spherocytes get stuck in spleen. RBCs are small round, lack central pallor and have increased MCHC and RDW
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What is MAHA? What conditions are ass'd with it?
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Microangiopathic hemolytic anemia. Seen in DIC, TTP, HUS, SLE or malignant hypertension. ++ intravascular hemolysis with schistocytes and helmet cells
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What is DIC?
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Disseminated intravascular coagulation. Global activation of clotting cascade, with consumption of clotting factors and platelets.
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What conditions lead to DIC?
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Sepsis (gram-), trauma (major), obstetric complications (commonest cause), pancreatitis (acute), malignancy, nephrotic syndrome, transfusion
mnemonic: (STOP Making New Thrombi) |
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Lab findings in DIC?
a) PT b) aPTT c) D-dimers d) platelet count e) blood film |
a) increased
b) increased c) increased d) decreased e) schistocytes and helmet cells |
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What conditions are ass'd with intravascular hemolysis?
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PNH, HUS, TTP, DIC, SLE, malaria
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What fusion protein and chromosomal translocation is seen classically in CML?
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The bcr-abl kinase, formed by t(9;22), the Philadelphia chromosome.
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What is the translocation and gene classically ass'd with Burkitt's?
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t(8;14); c-myc
the Ig heavy chain promoter (chromo 14) is rearranged to beside the c-myc oncogene. most B-cell neoplasms are associated with chr 14 rearrangments (Ig locus) |
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which translocation and gene are classically associated with follicular lymphoms
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t(14;18); bcl2
(recall chr 14 and the IgH locus in B cell tumours) |
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which translocation is classically ass'd with the M3 type of AML and what is the implication?
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t(15;17) associated with retinoic acid receptor and therefore responsive to treatment with all-trans retinoic acid
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which translocation is ass'd with Ewing's sarcoma?
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t(11;22)
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which translocation is ass'd with mantle cell lymphoma?
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t(11;14)
(recall chr 14 and the IgH locus in B cell tumours) |
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what are the four calssical types of Hodgkins lymphoma?
the non-classical? |
Nodular sclerosing (65%) - prognosis good
Lymphocyte predominant - good Lymphocyte poor - bad Mixed cellularity - intermediate nodular predominant L&H - actually a B cell lymphoma - prognosis very good |
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what virus is ass'd with lymphoma
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EBV - ass'd with Burkitt's and Hodgkins
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What are "B" symptoms?
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Fever, night sweats, weight loss - ass'd with worse prognosis in Hodgkins disease
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Where is the defect in Glanzmann's thrombasthenia?
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gpIIb/IIIa - defect in binding fibrin
defective platelet aGgregation |
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Where is the defect in Bernard-Soulier?
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gpIb - defect in binding vWF
defective platelet adhesion |
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Where are Auer rods seen?
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AML, esp M3 ie acute promyelocytic type;
peroxidase-positive cytoplasmic inclusions in granulocytes and myeloblasts; can be released by treatment, leading to DIC |
