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140 Cards in this Set
- Front
- Back
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heme synthesis - must have these two components
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1. iron
2. protoporphyrin |
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excess iron will be stored in tissue and body organs called what in when in the LUNGs and GI tract
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1. hemo--sider-o-sis (iron overload in LUNGS) SIDE of the LUNGS
2. hemo--chromat-o-sis (iron overload in the GI tract) CHROM of GI TRACT |
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what is transferrin function
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Fe TRANSPORT protein
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what is ferritin function
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major Fe STORAGE form
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what is hermo-siderin function
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H20 INSOLUBLE Fe storage form (long term), its an iron storage complex (ferritin being the other) found w/in cells as oppose to circulating)
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with PROPHYRIAS, what happens when excessive formation of porphyrins occurs if any emzymatic step in heme syhtesis is ____
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blocked
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name the 5 Heme precursors
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1. DELTA--aminolevulinic acid
2. POR--phobilinogen 3. UR--O--porphyrinogen 4. COP--porphyrinogen 5. PROTO--porphyrin heme + globin = hemoglobin while in the DELTA, POUR, YOUR COP, PRONTO, a cup of HEME |
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Protoporphyrin synthesis - porphyrias: emz deficiencies cause build up on heme precursors, what happens to the color of urine
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urine turns RED or PORT wine colored
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in the Porphyrias synthesis, name the early precursors (2) and what complications does it cause
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1. DELTA--aminolevulinic acid
2. POR--phobilinogen neuropsychiatric complication (ex: acute intermittent porphyria AIP) |
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in the Porphyrias synthesis, name the later precursors (3) and what complications does it cause
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3. UR--O--porphyrinogen
4. COP--porphyrinogen 5. PROTO--porphyrin heme + globin = hemoglobin cutaneous/skin complications such as photosensitivity, facial hair (werewolf legend) |
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what is Porphyrias
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Porphyrias are a group of inherited or acquired disorders of certain enzymes in the heme biosynthetic pathway They are broadly classified as acute (hepatic) porphyrias and cutaneous (erythropoietic) porphyrias, based on the site of the overproduction and accumulation of the porphyrins (or their chemical precursors)
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Red Cell Indices: MCV formula & RR
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HCT/RBC x 10
RR (micro) 80-100 (macro) fl indication of Micro anemia or Macro anemia |
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Red Cell Indices: MCH formula & RR
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HGB/RBC x 10
RR 28-32 pg varies w/ HGB content & cell size |
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Red Cell Indices: MCHC formula & RR
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HGB/HCT x 100
RR (hypo)32-36 (hyper)% hypochromic cell hyperchromic cell (spherocytes), Lipemia, HGB SS, CC |
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Red Cell Indices: RDW formula &RR
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SD of MCV x 100/Mean MCV
RR 11.5-14.5% >14.5 anisocytosis |
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name the following cell & its functions:
RBC |
O2 transport to tissue and CO2
removal from tissue cell nutrition |
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name the following cell & its functions: neutrophil
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phagocytic response to bacteria (sim to monocyte)
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name the following cell & its functions: lymphocyte
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humoral and cell mediate immunity
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name the following cell & its functions: monocyte
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phagocytic response to bacteria (sim to neutrophil)
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name the following cell & its functions: basophil
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inflammatory response mediator
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name the following cell & its functions: eosinphil
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allergic response regulator
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name the following cell & its functions: platelet
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clotting
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name percentage/RR & what would cause it to increase: neutrophils
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50-70%
increased in bacterial infection |
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name percentage/RR & what would cause it to increase: lymphocyte
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20-40%
increase in viral infection |
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name percentage/RR & what would cause it to increase: monocyte
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3-10%
increase in TB, syphilis, malignancies |
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name percentage/RR & what would cause it to increase: eosinophil
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0-3%
increase in allergies, parasites, CML (sim to basophil) |
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name percentage/RR & what would cause it to increase: basophil
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0-2%
increase in immediate hypersensitivity, CML (sim to eos) |
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name the WBC cells from most to least based on the reference ranges starting with Neutrophil
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1. neutrophils 50-70%
2. lymphocytes 20-40% 3. monocyte 3-10% 4. eos 0-3% 5. baso 0-2% |
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this morphology is associated with what kind of disease:
hypersegmented neutrophil |
pernicious anemia
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this morphology is associated with what kind of disease: hyposegemented neutrophils (4)
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Pelger Huet Anomaly
Pseudo-Pelger Huet AML AIDS |
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this morphology is associated with what kind of disease: toxic granulation & vacuoles (3)
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Bacterial infection
Burns Chemotherapy (vs May Hegglin for Dohle bodies) |
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this morphology is associated with what kind of disease: Dohle Bodies (RNA) (3)
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Bacterial infection
Burns May Hegglin (vs Chemo for toxic granulatx & vacuoles) |
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this morphology is associated with what kind of disease: Atypical lymphs (increase size & basophilia)
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IM
Epstein barr virus other viral infection remember that lymphs are increased in viral infections |
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this shape is seen in what disease: acanthocyte
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Abetalipoproteinemia (aka Bassen Kornz Weig syndrome)
severe Liver disease caused by formation cause by alternation of lipid compostx & fluidity of cell membrane |
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this shape is seen in what disease: echinocyte "burr" cell
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Uremia
Artifact (alkaline glass effect) "crenated RBC" cause hyperosmotic solution & are ass w/ malnutritx |
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this shape is seen in what disease: elliptocyte aka "cigar" shaped
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hereditary elliptocytosis (>50%)
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this shape is seen in what disease: macroovalocyte
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megaloblastic anemia
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this shape is seen in what disease: helmet (keratocyte)
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hemolytic process
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this shape is seen in what disease: schistocyte (RBC fragments) aka bite cells
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DIC and hemolytic processes
the membrane damage cause during passage to vessels |
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this shape is seen in what disease: sickle cell (drepanocyte & crescent shape)
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HGB SS
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this shape is seen in what disease: spherocyte (no CENTRAL pallor)
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Hereditary spherocytosis
Increase MCHC ABO HDN other Hemolytic processes |
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this shape is seen in what disease: stomatocyte (mouth cell)
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Hereditary stomatocytosis (>50%)
Liver disease cause by lost of indentation of one side = mouth cell |
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this shape is seen in what disease: target cell (codocyte)
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liver disease
HGB C and other Hemoglobinopathies |
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this shape is seen in what disease: teardrop cells (dacryocyte)
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extramedullary hematopoiesis:
mylofibrosis myeloproliferative disorders p. anemia thalassemia "pear shape" w/ tapered end |
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this red cell inclusion is composed of & what stain does it use: Howell Jolly Body
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DNA
Wright stain |
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this red cell inclusion is composed of & what stain does it use: Basophilic Stippling
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RNA
Wright stain New Methylene Blue |
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this red cell inclusion is composed of & what stain does it use: Pappenheimer Bodies Siderotic Granules (siderocyte)
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Iron
Wright Prussian Blue |
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this red cell inclusion is composed of & what stain does it use: Heniz Body
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Denatured precipitate HGB
Superviral stain example: Brillian Cresyl Blue or New Methylene Blue (NOT see w/ Wright Stain) |
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this red cell inclusion is composed of & what stain does it use: Cabot Ring
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Remnants of Miototic Spindle
Wright stain |
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this red cell inclusion is composed of & what stain does it use: Parasites
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use Wright
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Howell JB is composed of DNA what would this indicate (4)
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disturbed erythropoiesis
hemolytic anemia megaloblastic anemia post splenectomy |
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Basophilic Stippling is composed of RNA what would this indicate (2)
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thalassemia
lead poisoning |
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Papperheimer body Siderotic Granules are composed of Iron what would this indicate (3)
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sideroblastic anemia
hemoglobinopathies (severe anemia or thlassemia) "pepper body w/ fat SIDES" |
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Heniz body is composed of denatured PPT HGB what would this indicate (3)
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G6PD
Thalassemia Unstable HGB |
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Cabot Ring is composed of remnant of mitotic spindle what would this indicate
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megaloblastic anemia
(mega RING) |
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quick thought: Malaria is caused by which vector
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MMMMMosquito
ring form, or double dot ring (open) |
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quick thought: Babesia is caused by which vector
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Ticks
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quick thought: Trypansomes is caused by which vector
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Fleas
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HGB S structural mutation involves what substitution on the beta chain
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Valine for Glutamic Acid
6th position, beta chain Sr. Varsity = VVValine |
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HGB C structural mutation involves what substitution on the beta chain
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Lysin for Glutamic Acid
6th position, beta chain CL mercedes |
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Structural mutation on HGB D is found in which population and migrates with which HGB
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East Indian people
migrates w/ HGB S at 8.6 east indian Score a D on their test |
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Structural mutation on HGB E is found in which population and migrates with which HGB
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Southeast Asian people
migrates w/ HGB C and A2 at 8.6 (hypochromic, microcytic) asian people enjoy Eating and Cooking |
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Low MCV
*Problem with Heme name (3) examples |
Low MCV
Iron Defcny Sideroblastic Chronic Disease/Inflammation |
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Low MCV
*Problem with Globin name (2) examples |
Low MCV
Thalassemia HGB E |
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Normal (normocytic)
**give examples Antibody destruction conditions (3) |
HDN
Transfusion reaction Autoimmune hemolytic anemia |
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Normal (normocytic)
**give examples RBC membrane defect conditions (3) |
Hereditary spherocytosis (HS)
Hereditary Elliptocytosis (HE) Paroxysmal Noctural Hemoglobinuria (PNH) |
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Normal (normocytic)
**give examples Emz deficiency conditions (2) |
G6PD
Pyurvate Kinase (PK) |
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Normal (normocytic)
**give examples decrease production, loss conditions (2) |
Aplastic anemia
Acute blood loss |
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Normal (normocytic)
**give examples Hemoglobinopathies conditions (2) |
HGB S
HGB C other variants |
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High (macrocytic)
**give examples Megaloblastic maturation conditions (2) |
B12 defncy
Folate defncy |
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High (macrocytic)
**give examples Non-megaloblastic maturation conditions (1) |
Liver disease
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with the lab findings, name the Anemia
decrease FE increase TIBC (vs decrease TIBC = chronic dz/inflmatx) decrease %Saturation |
Iron defncy
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with the lab findings, name the Anemia
decrease FE decrease TIBC (vs increase TIBC = iron defncy) |
Chronic disease/inflammation
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with the lab findings, name the Anemia
Basophillic Stippling Increase Blood Lead level increase FEP |
lead poisoning
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with the lab findings, name the Anemia
Normal: Fe Norma: TIBC increase in A2 increase F |
Thalassemia trait
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with the lab findings, name the Anemia
decrease B12 decrease Retics Pancytopenia Oval macrocytes Hypersegemented Polys HJ bodies |
B12 defncy
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with the lab findings, name the Anemia
Anti-IF + (intrinsic factor) increase MMA (methylmalonic acid) increase Homocysteine Normal Schilling Test with IF |
Pernicious anemia (PA)
versus Malabsorption & Folate Defncy has Anti-IF -- |
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with the lab findings, name the Anemia
Anti-If -- (intrinsic factor) Abnormal Schilling Test with and without IF |
Malabsorption
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with the lab findings, name the Anemia
decrease Serum/erythrocyte folate level Oval macrocytes Anti-IF -- decrease Retics hypersegmented Polys increase Homocysteine HJ bodies |
Folate defncy
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with the lab findings, name the Anemia
increase in Liver emz Target cells Round Macrocytes |
Liver disease/Alcoholism
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with the lab findings, name the Anemia
increase in Bili decrease Haptoglobin DAT + |
antibody mediated
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with the lab findings, name the Anemia
that caused the antibody mediated condition: Donath Landsteiner Ab increase Bili decrease Haptoglobin DAT + |
PCH
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with the lab findings, name the Anemia that caused the antibody mediated condition:
IgM antibody Cold Agglutinin Titer + increase Bili decrease Haptoglobin DAT + |
Cold Agglutinin Disease
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with the lab findings, name the Anemia that caused the antibody mediated condition:
IgG antibody increase Bili decrease Haptoglobin DAT + |
Warm autoimmune hemolytic anemia
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with the lab findings, name the Anemia that caused the membrane defect condtx:
increase Osmotic fragility Sperocytes increase MCHC |
Hereditary spherocytes
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with the lab findings, name the Anemia that caused the membrane defect condtx:
Elliptocytes >15 - 100% |
Hereditary elliptocytosis
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with the lab findings, name the Anemia that caused the membrane defect condtx:
Ham Test + Sucrose hemolysis + CD 55 -- CD 59 -- |
PNH
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with the lab findings, name the Anemia that caused the emz defect condtx:
decrease G6PD Heniz bodies |
G6PD
cause by x-link disease G6PD likes Heinz ketcup |
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with the lab findings, name the Anemia that caused the emz defect condtx:
decrease PK no Heinz body |
Pyruvate Kinase (PK) which is an emz inv w/ glycolysis
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with the lab findings, name the Anemia that caused an increase/decrease production condtx
"Dry tap" BM Hypocellular BM decrease Retics Pancytopenia |
Aplastic anemia
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with the lab findings, name the Anemia that caused an increase/decrease production condtx
Normal BM increase Retics |
Acute blood loss
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if you were able to see a definitive Poikylocytes on smear (HBC crystals, sickle cells, SC crystals etc) on HGB electrophoresis, what kind of defect would this be
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HGB defect
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name the following Hereditary Condtx:
has ineffective killing of bacteria |
Chronic Granulomatous Disease (CGD)
x-linked |
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name the following Hereditary Condtx:
has large Azurophilic granules |
Alder-Reily
increase muco-poly-saccharides (Hunter, Hurler) |
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name the following Hereditary Condtx:
has large Lysosomes (Fusion of primary granules) |
Chediak Higashi
Albinism increase susceptibility to infection |
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name the following Hereditary Condtx:
has large Platelets decrease # of Dohle Bodies in segs, mono & lyphms |
May Hegglin
does not affect leukocyte functions |
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name the following Hereditary Condtx:
has Hyposegmented Polys |
Pelger Huet
normal function |
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what is the following AML has predominant cell seen
M0 |
Myeloblast w/out diff
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what is the following AML has predominant cell seen
M1 |
Myeloblast w/ minimal maturation
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what is the following AML has predominant cell seen
M2 |
Myeloblast w/ maturation
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what is the following AML has predominant cell seen
M3 |
Promyelocyte (APL)
PRO series at level 3 |
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what is the following AML has predominant cell seen
M4 |
Myeloblast & monoblast (AMMoL)
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what is the following AML has predominant cell seen
M5 |
Monoblast (AMoL)
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what is the following AML has predominant cell seen
M6 |
Erythrocytic series
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what is the following AML has predominant cell seen
M7 |
Megakaryocyte
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which of the following belongs to: Leukemoid reactions or CML
increase LAP increase Toxic Granules Dohle Bodies seen + Philadelphia Chromosomes -- (neg) |
Leukemoid
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which of the following belongs to: Leukemoid reactions or CML
decrease LAP decrease Toxic Granules Dohle Bodies neg Philadelphia Chromosomes + |
CML (chronic myelocytic leukemia)
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which of the following belongs to:
Hodgkin vs Non Hodgkins present: Reed Sternberg cell incidence: bi-modal spread: stepwise (predictable) |
Hogkins
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which of the following belongs to:
Hodgkin vs Non Hodgkins absent: Reed Sternberg cell incidence: NO PATTERN spread: unpredictable |
Non Hogkins
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this test measures RBC surface: Volume ratio by using salt tolerance to help detect the following
increase Hereditary Spherocytosis decrease in Thalassemia, Target cells |
Osmotic fragility
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this test measures complement mediated lysis that helps indicate the following
PNH |
Ham's acid hemolysis which is a definitive test vs Sucrose hemolysis who is only a screen test
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this test measures effect of complement (activated by sucrose) on RBC that helps indicate the following -- used for screen only
PNH |
Sucrose hemolysis (sugar water)
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this test measures effect of oxidizing agent on hemoglobin to help indicate the following
G6PD defncy Unstable HGB HGB H |
Heniz Body prep
formation triggered by Oxidants such a s Anti-Malarial Drugs, Fava Bean & Sulphur drugs |
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this test measures reduced solubility of deoxygenated HGB S that helps indicate the following
HGB S |
Sickle cell screen
reducing agent: Na Dithionate |
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this test measures resistance to fetal HGB to acid elution, that helps indicate
fetal maternal Hemorrhage Hereditary persistence of Fetal HGB |
Kleihauer Betke Acid Elution
cells w/ increase HGB F stain pink normal adults cells = GHOST cells |
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this test measures migration of various HGB by indicating suspected hemoglobinopathies
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HGB electrophoresis
may be performed at various pHs |
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this test measures presence of cold autoantibody that indicates the following
Cold autoimmune hemolytic anemia |
Cold agglutinin screen
IgM anitboy, Anti-I specificity |
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this test measures presence of Biphasic DL antibody by indicating the following
Paroxysmal Cold Hemoglobinuria |
Donath Landsteiner Test
IgG antibody, Anti-P specificity |
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which one am I: Multiple Myeloma or Waldenstrom
Bone involvement: Yes Serum Viscosity: +/-- Immunoglobulin: IgG (Bence Jones) |
Multiple Myeloma
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which one am I: Multiple Myeloma or Waldenstrom
Bone involvement: No (organ) Serum Viscosity: INCREASE Immunoglobulin: IgM (Heavy Chain) |
Walderstrom
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name the Lysosome/Lipid Storage Disease
LAB ID: Macrophage ACC LIPID: Glucocerebroside |
Gaucher
macrophage Cytoplasm looks like an unfolded crumpled piece of paper |
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name the Lysosome/Lipid Storage Disease
LAB ID: Macrophage ACC LIPID: Sphingo--myelin |
Niemann Pick
macrophage has globular cytoplasm sea blue histiocytes |
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name the Lysosome/Lipid Storage Disease
LAB ID: Vaculoated lymphocytes, Foam cells (BM) ACC LIPID: Sphingo--lipids |
Tay sach
diagnosed by increase Startle Reflex, Cherry Red spot in macular of eye & CNS studies |
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name the Lysosome/Lipid Storage Disease
LAB ID: large granules in Lymphocytes, Alder Reilly Bodies, also in Histiocytes & Lymphocytes (BM) ACC LIPID: Muco-poly-saccharides |
Hurler Hunter
unmetabolized products detected in urine (toluidine blue spot test) |
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which stain indicates glycogen and has significance in the following:
Erythroleukemia, ALL (Chunky +) |
Periodic Acid Schiff (PAS)
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which stain indicates Iron and has significance in the following:
Sideroblastic anemia |
Prussian Blue
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which stain indicates Alkaline phosphatse and has significance in the following:
increase Leukamoid Rtx P. vera decrease CML |
LAP
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which stain indicates Myeloperoxidase/Lipid and has significance in the following:
AML: M1 - M4 + AML: M5 - ALL - |
Peroxidase/Sudan Black
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which stain indicates esterase in granulocyte precursors and has significance in the following:
AML: M1 - M4 + AML: M5 -- |
Specific Esterase
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which stain indicates non specific esterase in Monocyte precursors and has significance in the following:
AML: M4+ AML: M5++ (w/ Fluoride inhibition step, M5 --) |
Non specific Esterase
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which stain indicates tartrate resistant acid phosphatase and has significance in the following:
Hairy Cell Leukemia |
TRAP
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which stain indicates abnormal granulocyte function and has significance in the following:
Chronic Granulomatous Disease |
Abnormal NBT
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which stain indicates coalition of 1 degree granules and has significance in the following:
AML + ALL -- |
Auer rods
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which stain indicates Myeloblasts and has significance in the following:
AML + ALL -- |
CD 13
CD 33 |
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which stain indicates T-lineage and has significance in the following:
T-ALL + B-ALL -- AML -- |
CD 2
CD 3 CD 5 CD 7 |
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which stain indicates B-lineage and has significance in the following:
T-ALL -- B-ALL + AML -- |
CD 10 (CALLA)
CD 19 CD 22 |
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which stain indicates chromosomes translocation inv Retinoic Acid Receptor Gene and has significance in the following:
Acute Progranulocytic Leukemia (AML M3) treated w/ ATRA (ALL Trans Retinoic Acid) |
t (15, 17)
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which stain indicates steam cells and has significance in the following:
stem cells for transplantation |
CD 34
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which stain indicates Megakaryocytes and has significance in the following:
AML M7 |
CD 42, CD 61
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which stain indicates Monoblasts and has significance in the following:
AML M4 & AML M5 |
CD 116
CD 14 |
