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71 Cards in this Set
- Front
- Back
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What is the WBC differential from highest to lowest
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Neutrophils
Lymphocytes Monoctyes Eosinophils Basophils "Neutrophils Like Making Everything Better? |
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what do thrombocytopenia or platelet dysfunction result in
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petechiae
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what types of granules do platelets contain
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dense: ADP, Ca
alpha: vWF, fibrinogen |
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where is 1/3 of the platelet pool stored
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in the spleen
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what is the lifetime of the RBC
what is the lifetime of the platelet |
120 days
8-10 days |
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what are the 2 types of leukocytes and give ex.
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granulocytes (basophils, eosinophils, neutrophils)
mononuclear cells (monocytes, lymphocytes) |
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what are in basophil granules
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heparin, histamine, and other vasoactive amines and leukotrienes (LTD-4)
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what drug is used to prevent mast cell degranulation (asthma treatment)
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cromolyn sodium
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what do eosinophils produce
what is the function of the mediators released |
histaminase and arylsulfatase -- help limit the rxn following mast cell degranulation
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what are the causes of eosinophilia
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NAACP
Neoplasm Asthma Allergic processes Collagen vascular dz Parasites |
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in what condition do you see hypersegmented polymorphonuclear cells (PMN)
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Vit B12/Folate deficiency
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what cell has a "frosted glass" cytoplasm
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monocyte
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what cytokine activates macrophages
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IFN-gamma
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what are the main inducers of primary antibody response
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dendritic cells
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what are Langerhans cell
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dendritic cells on the skin
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where are B cells located in the periphery
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follicles of lymph nodes,
white pulp of spleen unencapsulated lymphoid tissue |
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what is a plasma cell neoplasm
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multiple myeloma
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what cell has a clock-face chromatin distribution, and an off-center nucleus
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plasma cell
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what blood group is the universal recipient
what blood group is the universal donor |
recipient: AB
donor: O |
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what is erythroblastosis fetalis
what causes it |
hemolytic dz of the newborn
anti-Rh IgG Ab made by Rh mother that attacks fetus w/Rh+ blood |
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How do you prevent future erythroblastosis fetalis
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Rh antigen Ig given to mother after delivery
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what causes Hemophilia A
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deficiency of factor VIII (8)
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what causes Hemophilia B
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deficiency of factor IX (9)
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what activates bradykinin
what inactivates bradykinin |
kallikrein activates
ACE inhibits |
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What is Vit K deficiency
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decreased synthesis of factors 2, 7, 9, 10, protein C, and protein S
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what does antithrombin do
what activates antithrombin |
inhibits thrombin and factors: 9a, 10a, 11a, 12a
heparin activates |
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what does bradykinin do
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increases:
vasodilation, pain, permeability |
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how are plasmin and the complement cascade connected
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plasmin converts C3 to C3a
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what does the extrinsic coagulation pathway start with
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Tissue factor (thromboplastin) and Factor VII (7)
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what is thromboplastin
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tissue factor
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what are the components of platelet plug formation
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adhesion, aggregation, swelling
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what is adhesion (platelet plug formation)
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vWF mediates link of platelet GpIb receptor to subendothelial collagen
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what is aggregation (platelet plug formation)
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balance w/pro and anti-coagulation
TXA2 increases aggregation (released by platelets) NO, PGI2 decrease aggregation (released by endothelial cell) |
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what is swelling (platelet plug formation)
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binding of ADP on platelet receptor -> GpIIb/IIIa insertion on platelet membrane (initially intracellular) -> allows platelet cohesion (Ca also strengthens platelet plug)
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how does aspirin work on platelets
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inhibits COX, inhibiting TXA2 synthesis
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how do ticlopidine and clopidogrel work
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inhibits ADP-induced expression of GpIIb/IIIa
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What drug inhibits GpIIb/IIIa directly
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Abciximab
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what does vonWillebrand's factor do
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carries/protects factor VIII (8)
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How does Vit K get activated
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epoxide reductase activates Vit K
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how does warfarin work
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inhibits epoxide reductase, blocking Vit K activation
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what factors does antithrombin inhibit
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2, 7, 9, 10, 11
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What activates Protein C into APC (activated Protein C)
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Protein S and thrombomodulin from endothelial cells
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what does Protein C
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cleaves and inactivates 5a, 8a
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What is Factor V Leiden mutation
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produces a factor V resistant to APC's inhibition
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how does tPA work
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blocks plasminogen conversion to plasmin
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when do you see bite cells
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G6PD deficiency
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when do you see acanthocytes (spur cells)
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liver dz, abetalipoproteinemia
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when do you see schistocyte, helmet cell
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DIC, TTP/HUS, traumatic hemolysis
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When do you see target cells
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HbC dz, Asplenia, Liver dz, Thalassemia
"HALT, said the hunter to his Target" |
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what do Heinz bodies lead to
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bite cell formation
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What are Heinz bodies
when do you see them |
oxidation of iron from ferrous to ferric form -> denatured Hb precipitation and damage to RBC membrane
seen is alpha-thalassemia, G6PD deficiency |
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what are the pathologic RBC forms seen in G6PD deficiency
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bite cells and Heinz bodies
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when do you see Howell-Jolly bodies
what are they |
in functional hyposplenia, asplenia
they are basophilic nuclear remnant found in RBCs |
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what does Hb Barts lead to
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hydrops fetalis
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what is alpha-thalassemia
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decreased alpha-globin synthesis b/c of a mutation in alpha-globin gene
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what is Hb Barts
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4 gamma globins
deletion of 4 alpha globin gene -> incompatible with life -> hydrops fetalis |
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what happens when there are 3 gene deletions in alpha-thalassemia
what happens when there are 1-2 gene deletions |
3 gene: HbH dz (beta4)
1-2 gene: NOT assoc w/anemia |
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what is the defect in beta-thalassemia
what Hb is present in both types |
point mutations in splicing sites and promoter sequences
increased HbF |
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what are the 2 types of B-thalassemia
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Minor (heterozygote) and Major (homozygous)
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what is B-thalassemia minor
how is the dx confirmed |
heterozygous
B chain is underproduced asymptomatic dx: confirmed by increased HbA2 (>3.5%) |
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what is B-thalassemia major
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homozygous
B chain is absent -> severe anemia requiring blood transfusion (secondary hemochromatosis) -marrow expansion ("crew cut" on skull X-ray) -> skeletal deformities -Chipmunk facies |
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what anemia has chipmunk facies
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b-thalassemia major
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what anemia causes a secondary hemochromatosis
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B-thalassemia major b/c of blood transfusion required for severe anemia
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what is a HbS/B-thalassemia heterozygote
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mild to moderate sickle cell dz depending on amt of B-globin production
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how does Lead poisoning work
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inhibits ferrochelatase and ALA dehydratase -> decreased heme synthesis
inhibits RNA degradation -> basophilic stippling |
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what is the defect in sideroblastic anemia
what are the reversible etiologies |
defect in heme synthesis
X-linked defect in delta-aminolevulinic acid synthase gene EtOH, lead |
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What are the lab findings in sideroblastic anemia
How do you treat it |
Labs: increased iron, NL TIBC, increased ferritin
Trx: Pyridoxine (B6) therapy |
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What is the histology in sideroblastic anemia
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ringed sideroblasts w/iron-laden macrophages
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what are the microcytic, hypochromic anemias
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Fe deficiency
a-thalassemia B-thalassemia Lead poisoning Sideroblastic anemia |
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what is PT
What does it test |
Prothrombin Time
extrinsic pathway tests function of factors 1, 2, 5, 7, 10 |
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what is PTT
What does it test |
Partial Thromboplastin Time
intrinsic pathway tests fxn of ALL factors, EXCEPT 7 and 13 |
