Hematopoietic And Lymphoreticular System 2

Front 1

Platelets - Qualitative disorders are either?

Back 1

acquired or congenital

Front 2

Platelets - Qualitative disorders

Aquired

Back 2

1. drug induced--> by far the most important of the qual disorders
*aspirin exposed platelets do not adhere but they do aggregate
2. myeloproliferative disorders
3. Uremia

Front 3

Platelets - Qualitative disorders

Congenital

Back 3

1. Bernard Soulier's disease
2. Glansman's disease
3. Storage pool disease

Front 4

****What are the four "D's" of Quantitative Thrombocytopenia?


"The greatest thing since sliced bread"

Back 4

1. Decreased production
2. Dilution (massive transfusions for example)
3. Distribution (normal amounts of platelets but are [] somewhere)
4. Increased Destruction

Front 5

What are some examples of Decreased production leading to Thrombocytopenia?

Back 5

aplastic anemia, congenital, drug induced, marrow infiltration, nutrional, post chemo/radiation, paroxysmal nocturnal hemoglobinuria, viral

Front 6

Increased Destruction: Thrombocytopenia

Back 6

-enough are produced but are being destroyed in the periph
-probably the most important of the Ds

Front 7

Thrombocytopenia:
Increased Destruction Examples

Back 7

-congential
-DIC
-Hemolytic Uremic Syndrome (HUS)
-Idiopathic Thrombocytopenic Purpura
-Post transfusion purpura
-Thrombotic Thromocyt purpura

Front 8

Idiopathic Thrombocytopenic Purpura (ITP)

Back 8

-Ab against platelet surface Ag, destroyed by immune system
-tx w/ steroids

Front 9

****Thrombotic Thrombocytopenic Purpura (TTP)

Back 9

Pentad of symptoms
-micro angioplastic hemolytic vascular problem--> the RBCs are being cut--> schistocytes

Front 10

****Thrombocytosis

Myeloproliferative disorders

Back 10

-chronic myelocytic leukemia
-Erythroblastic leukemia
-hyper-eosinophilia syndrome
-primary thrombocythemia
-myelofibrosis w/ myeloid metaplasia
-polycythemia vera--> premalig disease (too many of all cells)

Front 11

***WBC disorders 1

Back 11

1. acute leukemia (neoplastic WBC in the marrow
2. Chronic leukemia
3. Lymphoma (neoplastic WBC in the lymph)
4. Myelodysplastic syndromes

Front 12

***Myeloid vs Lymphoid WBC disorders

Back 12

1. Myeloid: from the BM
-includes precursors of granulos (neutros, basos, eosinos), monocytes, RBCs, Platelets
2. Lymph: nodes, thymus, spleen
-includes lymphos from the periph blood, lymph nodes and extranodal tissues

Front 13

Acute vs Chronic WBC disorders

Back 13

1. Acute: agressive clinical course (months), young malig cells predominate (blasts), "blastic"
2. Chronic:slow (years), mature malig cells predominate, "cytic"

Front 14

Overview of Myeloproliferative Disorders

Back 14

-disease of adults
-stem cell disorder: myeloid cell line is part of malig clone
-mature cells predominate
-*periph blood shows inc plates in ALL MPD except fibrotic stage of myelofibrosis
-BM shows hypercellularity

Front 15

Myeloproliferative Disorders involving:

granulocytes, basos, eosinos

Back 15

Chronic myeloid leukemia

Front 16

Myeloproliferative Disorders involving:

RBCs

Back 16

Polycthemia Vera

Front 17

Myeloproliferative Disorders involving:

Platelets and Megakaryocytes

Back 17

-Essential thrombocythemia Myelofibrosis

Front 18

Myeloproliferative Disorders involving:

Monocytes

Back 18

-Chronic Myelomonocytic Leukemia

Front 19

Myelo-Dysplastic Syndromes - FAB classification

Back 19

-myelodysplastic syndrome
-refract anemia (w/ ringed Sideroblast), (w/ excess blasts)
-chronic myelomonocytic leukemia
-refractory anemia w/ excess blasts in transformation

Front 20

***WBC disorders 2

Back 20

1. myeloproliferative disorders
2. Plasma cell disorders
3. other WBC disorders

Front 21

****PLASMA CELL DISORDERS

Back 21

-multiple myeloma
-LC disease, HC disease
-Benign monoclonal gammopathy
-Waldenstroms macroglobulinemia
-Amyloidosis
-Plasmacytoma
-Plasma cell leukemia
-Monoclonal gammopathy of undetermined significance

Front 22

How to evaluate for coagulopathy?

Back 22

-Hx and PE, but not enough
-CBC w/ smear
-PT (prothrombin time)
-INR (International normalized ratio)
-PTT (partial thromboplastin time)
-Platelet count

Front 23

Prothrombin Time (PT)

Back 23

-extrinsic pathway:
factors II, V, VII, X and fibrinogen

Front 24

INR (International normalized ratio)

Back 24

-ratio of pt's PT to a normal PT

Front 25

PTT (partial thromboplastin time)

Back 25

-factors VIII, IX, XI, XII and rarely Von Willebrand's factor

Front 26

Congenital Coagulation Disorders

Back 26

-Factor deficiencies (I-XII)
-Dys-fibrinogemia
-Fletcher Trait
-Fitzgerald Trait
-Von Willebrand's Disease

Front 27

****Hypercoagulable states

Back 27

-inherited defect of anti-clot enzymes
a. Protein C deficiency
b. Protein S deficiency
-HIT Ab

Front 28

Pentad of symptoms for TPP

Back 28

1. Microangioplastic hemolytic anemia
2. Fever
3. Mental Status change
4. Renal dysfunction
5. Thrombocytopenia