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56 Cards in this Set

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Basophilic Stippling
Lead Poisoning
What am I and what disease am I seen in?
Basophilic Stippling
Bite cells
Any hemolytic anemia
What am I and what disease am I seen in?
Bite cells
Echinocyte or burr cell
Uremia
What am I and what disease am I seen in?
Echinocyte or burr cell
Heinz body
G6PD deficiency
What am I and what disease am I seen in?
Heinz body
Howell-Joly bodies
Asplenia, splenic dysfunction
What am I and what disease am I seen in?
Howell-Joly bodies
Howell-Joly bodies
Asplenia, splenic dysfunction
What am I and what disease am I seen in?
Howell-Joly bodies
hypersegmented neutrophil
folate or B12 deficiency
What am I and what disease am I seen in?
hypersegmented neutrophil
Iron inclusions in bone marrow RBC
Sideroblastic anemia
What am I and what disease am I seen in?
Ring of iron inclusions
Parasite in RBC
Malaria
What am I and what disease am I seen in?
parasite
Parasite in RBC
babesiosis
What am I and what disease am I seen in?
parasite in RBC
Polychromasia
Reticulositosis (consider hemolysis)
What am I and what disease am I seen in?
Polychromasia
Rouleaux formation
Multiple myeloma
What am I and what disease am I seen in?
Rouleaux formation
Schistocytes and helmet cells
Intravascular hemolysis
What am I and what disease am I seen in?
Schistocytes and helmet cells
Target cell
Thalessemia, liver disease
What am I and what disease am I seen in?
target cell
Teardrop cell
Myelofibrosis
What am I and what disease am I seen in?
Teardrop cell
Acanthocyte
abetalipoproteinemia
What am I and what disease am I seen in?
Acanthocyte
What medications can cause anemia?
methyldopa (-->rbc abs)
chloroquine and sulfa drugs (in G6PD def)
phenytoin (megaloblastic anemia)
chloramphenicol (aplastic anemia)
What are some examples of microcytic anemias?
Iron deficiency
Sideroblastic
Lead poisoning
Thalessemias
Sickle cell
Dx of iron deficiency anemia?
low serum iron
low serum ferritin
high TIBC
target cells
Si/Sx of iron deficiency anemia?
tachycardia, fatigue, pallor, smooth tongue, brittle nails, esophageal webs, pica
Dx of sideroblastic anemia?
high iron
nml to high TIBC
high ferritin
What are some causes of sideroblastic anemia?
Chronic alcoholism
Drugs (especially INH)
Genetic
Si/Sx of lead poisoning?
anemia, encephalopathy, seizures, ataxic gait, wrist/foot drops, renal tubular acidosis
BURTON'S LINES = blue/gray discoloration at gumlines
Tx of sideroblastic anemia?
sometimes responsive to vit B6
Dx of B-thal major
on electrophoresis - very low HbA, high HbA2, high HbF
Dx of B-thal minor
on electrophoresis - low HbA, high HbA2, nml HbF
What are some examples of macrocytic anemias?
Vitamin B12 deficiency
Folic acid deficiency
What drugs can cause folate deficiency?
methotrexate, bactrim (smx/tmp)
What are labs to dx B12 deficiency?
high serum methylmalonic acid, high homocysteine
What are labs to dx folate deficiency?
nml serum methylmalonic acid, high homocysteine
Dx of anemia of chronic dx?
low serum iron, nml/high ferritin, low TIBC
Hx of chronic inflamm
What are some etiolgoies of autoimmune hemolysis?
idiopathic
lupus
drugs(PCN)
leukemia
lymphoma

IgG mediated
What are si/sx of autoimmune hemolysis?
rapid onset
sphereocytes
high indirect bili
jaundice
low haptoglobin
high urine hemosiderin
What is the diagnostic lab in autoimmune hemolysis?
positive direct coombs.
Tx for autoimmune hemolysis
prednisone +/- splenectomy
cyclophosphamide for refractory dz
What are some etiologies of cold-agglutin disease?
idiopathic
Mycoplasma pneuo
CMV
EBV

IgM mediated
Si/sx of cold-agglutinin dz
anemia on exposure to cold or after URI
what are the diagnostic labs of cold-agglutinin dz?
+ cold-agglutinin test, +indirect coombs
Tx for cold-agglutinin dz
prednisone if severe, otherwise supportive
Which coag tests are abnl in vWF dz?
high PTT and BT
Which coag tests are abnl in hemophilia?
High PTT
Which coag tests are abnl in DIC?
High PT, PTT, and BT
Low plts n/low RBC
What other labs are abnl in DIC?
High fibrin split products, low fibrinogen
Low factor VIII
Which coag tests are abnl in ITP?
High BT
Low plt
What is the tx for ITP?
steroids (first-line)
splenectomy (second-line)
or cyclophosphamide
Which coag tests are abnl in TTP?
High BT
Low plt
Low RBC
What is the dx pentad for TTP?
hemolytic anemia
renal failure
thrombocytopenia
fever
neuro dz
What is the tx for TTP?
Plasma exchange or IVIG until dz abates, otherwise fatal
Which coag tests are abnl in liver failure?
High PT, n/high PTT
n/low plt
n/low RBC
Which coag tests are abnl in scurvy?
none!
What do you use to follow heparin?
PTT
What do you use to follow warfarin?
PT
What drugs can cause thrombocytopenia?
heparin
sulfonamides
valproate
What does the blood smear look like in autoantibody plt destruction?
microspherocytes
+ coombs test
What does the blood smear look like in DIC?
some schistocytes with high PT/PTT
What does the blood smear look like in TTP/HUS?
many schistocytes with nml/high PT/PTT