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81 Cards in this Set
- Front
- Back
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Contained in basophil granules… difference of basophils from mast cells in location…
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Heparin, histamine, LTD-4. Basophils in Blood, Mast cells in tissue
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Cells that help limit rxn following mast cell degranulation… what do they release to do that.
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Mast cells, release histaminase and arylsulfatase
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Main inducers of primary antibody response… what do they have on their surface…
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Dentritic cells, express MHC II and FcR on surface
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Activate Hagemann factor (XII)…
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Collagen/basement membrane/activated platlets; HMWK; kallikrien
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Takes prokallikrein to kallikrein… what does kallikrein do…
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XIIa. Kallikrein converts plasminogen to plasmin and XII XIIa and HMWK bradykinin
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Takes VII VIIa…
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Thromboplastin (TF) and Ca
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Converts XIII XIIIa…
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Thrombin
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Factors that are the same between intrinsic and extrinsic clotting pathways…
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X, V, II, I, XIII
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How is platlet bound to subendothelial collagen..
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vWF binds collagen and then Gpb bound to platlet binds vWF
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Causes expression of IIb/IIIa on platlet surface…
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ADP receptor binding w/ ADP
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Antithrombrin inactivates…
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Factors 2,7,9,10,11
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MOA of elevated ESR…
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Incr fibrinogen in plasma cells causes decr negative charge in RBCs promotes rouleaux incr ESR
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Cause both arterial and venous thrombosis…
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HIT, antiphospholipid syn, homocystinuria
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Basophilic stippling due to… causes of…
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rRN buildup from decr rRNA degradation. Causes of: baste the ox TAIL: Thals, ACD, Iron def, Lead poisoning
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Target cells caused by…
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HALT to the TARGET: HbC dx, Asplenia, Liver dx, Thals
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Heinz bodies due to… caused by…
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Oxidation of Fe leads to denatured Hb preceipitatoin. Seen in G6PD and a-thal
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Deletion of 4 copies of alpha Hb called… causes…
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Hb Barts (y4- which is highly affinity to O2, poor O2 delivery), causes hydrops fetals
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Defect in beta thals…
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Splice site mutations and promoter sequences
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Things in RBC that are inhibited by lead…
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Ferrochelatase (incr protoporphyrin/copro), ALA dehydratase (incr ALA), RNA degradation (stippling)
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Lab values in sideroblastic anemia…
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Incr Fe, normal TIBC, incr Ferritin
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Extrinsic hemolytic anemias…
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Autoimmune, microangiopathic (DIC, TTP), infxns
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Intravascular hemolytic anemias…
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PNH, Cold autoimmune, mechanical destrxn
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Causes of aplastic anemia…
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Chloramphenicol, benzene, NSAIDs, propylthiouracil, methimazole, radiation, Fanconis anemia, Parvovirus, EBV, HIV
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Tx for aplastic anemia…
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Antithymocyte Ig, cyclosporine- both to decr immune response; bone marrow transpx, transfusion, G-CSF or GM-CSF
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Signs and symptoms of methemoglobinemia…
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Decr SaO2, chocolate colored blood, cyanosis that does NOT correct w/ O2
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Findings in hereditary spherocytosis..
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Splenomegaly, small and round RBCs w/o central pallor, aplastic crisis w/ parvo B19, Howell-Jolley bodies, incr osmo fragility
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Mutation in HbC…
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Glu Lys (+ charge)
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Funxn of DAF… labs in PNH…
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DAF destabilizes C3,C5 convertase. PNH has incr urine hemosiderin
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Fe lab values in pregnancy/OCP use…
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Incr transferring, decr transferrin saturation. Normal everything else
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Tx of AIP…
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Glc and heme to block ALA synthase so delta-ALA doesn’t accumulate
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Affected enzyme in Porphyria Cutanea Tarda… accumulated substrate…
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Uroporphyrinogen decarboxylase. Accumulate uroporphyrin (tea-colored)
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Decr levels of heme incr activity of what enzyme…
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ALA dehydratase
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Name the platlet disorders and what lab values are seen…
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Bernard-Solier (Ib), Glanzmans (IIb-IIIa), ITP (IIb-IIIa abs), TTP (incr vWF multimers). Labs: decr PC and incr BT
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Tx of TTP… what should avoid…
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Plasma exchange. Do NOT give platlets
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Tx for hemophilia A or B…
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Cryoprecipitate (FFP)
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Causes of vit K deficiency…
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Decr bacterial syn in gut, fat malabsorption, cirrhosis, warfarin toxicity
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Lab values in vW dx… tx…
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Normal PC, incr BT, maybe incr PTT. Tx: desmopressin
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Causes of DIC…
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Sepsis, Trauma, Obstetric compications, Pancreatitis, Malignancy, Nephrotic syn, Transfusion
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Labs in DIC..
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Schistocytes, incr fibrin split products (D-dimer), decr fibrinogen, decr factors V and VIII
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Mutation in prothrombin mutation…
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Mutation in 3’ untranslated region- get venous clots
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MOA of protein C or S deficiency… findings…
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Decr ability to inactivate factors V and VIII. Incr risk of hemorrhage after administration of Warfarin
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Characteristics of Non-Hodgkins lymphoma…
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Assoc. w/ HIV & immunosuppression. Multiple, peripheral nodes and extranodal involvement. Majority involve B cells. Few constitutional signs
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Genetics of Burkitt’s lymphoma… indicative of sporatic form…
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T(8:14) c-myc gene moves next to heavy-chain Ig. Pelvis or abdomen involvement indicates sporatic
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Most common adult NHL…
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Diffuse large-B cell lymphoma
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Mycois fungoides/Sezary syndrome…
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Adult presenting w/ rash plaquenodule
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Waldenstrom’s macroglobinemia findings…
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M spike=IgM (not IgG like MM), hyperviscosity, No lytic bone lesions nor elevated Ca
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General findings in leukemia…
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Incr or decr leukocytes in blood, bone marrow failure anemia from decr RBCs, infxns, hemorrhage.
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TdT marker for…
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Pre B and pre T cells
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Indicates a better prognosis in ALL…
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t(12:21)
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Findings in SLL/CLL… how differentiate between the two…
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Smudge cells in periph blood, warm ab autoimmune hemolytic anemia. CLL has incr lymphocytosis
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Translocation for AML… what does it affect…
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t(15:17), affects PML-RARalpha fusion receptor (retinoic acid receptor)
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Langerhan’s cell histiocytosis definition… findings…
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Defective cells from monocyte lineage (dentritic Langerhans). Express S-100 and CD1a and have Birbeck granules. See bone pain and lytic lesions
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3 diseases that are JAK2 mutation positive..
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Polycythemia vera, Essential thrombocytosis, Myelofibrosis
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Polycythemia vera vs. Essential thrombocytopenia…
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Both are abnormal clone of stem cells sensitive to growth factors but ET is only megakaryocytes
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Use of heparin… SEs…
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Immediate anticoag for PE, stroke, acute coronary syn, MI, DVT. SEs: bleeding, HIT, osteoporosis.
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How does protamine suflate work…
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+ charged and binds negatively charged heparin
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How low-molecular wt heparins work… why good to use…
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Act more on Xa, have > bioavailability, 2-4X longer half life. No lab monoriting.
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MOA of HIT…
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Heparin bound platlets release PF4 which binds IgG causing platelet and endothelial cell activation. Some platlets destroyed and others are overactivated.
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MOA of lepirudin, argotroban…
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Directly bind thrombin
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Structure of heparin vs. warfarin…
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Heparin is large anionic, acidic polymer while warfarin is small and lipophilic
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MOA of antistreptilase (APSAC)…
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Enhances plasmin breakdown of fibrinogen to degradation products
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Changes in coagulation factors, platlet count while using thrombolytics (tPA, urokinase, etc)…
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Incr PTT, Incr PT, no change in platlet count
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Uses of clopidogrel/ticlopidine…
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Acute coronary syn, stenting, decr incidence of thrombotic stroke
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What happens in G2 phase and drugs that work there…
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Synthesis of components needed for mitosis. Bleomycin and etoposide work there
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Drugs that work in the S phase…
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Etoposide and antimetabolites (MTX, 5FU, 6MP, 6TG, ara-C)
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Uses of MTX… SEs…
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Uses: leukemias, lymphomas, chorioCA, sarcomas. Abortion, ectopic prego, RA, psoriasis. SEs: myelosuppression, macrovesicular fatty change, mucositis, teratogen
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MOA of 5FU… uses… SEs and how tx overdose…
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Analog (5F-dUMP) covalently complexes w/ folic acid. Uses: colon CA, basal cell CA, synergy w/ MTX. SEs: myelosuppression NOT reversible w/ leukovirin; tx overdose w/ thymidine
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Activates 6-MP… uses… SEs…
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HGPRTase activaes, XO metabolizes. Tx leukemias and lymphomas besides HL or CLL. SEs: aplastic anemia when used w/ allopurinol, myelosuppresion, LIVER and GI issues
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If patient w/ ALL is taking allopurinol for gout, what would be a good antimetabolite drug choice…
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6-thioguanine
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MOA of cytarabine… use… SEs…
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Pyrimidine antagonist that inhibits DNA poly. Uses: ALL, AML, NHL. SEs: leucopenia, thrombocytopenia, megaloblastic anemia
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MOA of dactinomycin… use… SE…
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Intercalates DNA. Uses: Wilms, Ewings, Rhabdomyosarcoma (childrens tumors). Myelosuppression
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Drugs used to tx Hodgkins…
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Adriamycin (doxorubicin), Bleomycin, Vincristine/blastin, D??
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SEs for busulfan and bleomycin… how do they differ…
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Pulm fibrosis and skin changes but bleomycin doesn’t have much, if any, myelosuppression
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Use and SEs of etoposide…
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Uses: small cell CA, testicular CA. SEs: myelosuppression, GI, irritation, alopecia
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MOA of cyclophosphamide and ifosfamide… uses… SEs…
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Covalently X-link DNA at guanine N-7. require bioactivation by liver. Uses: NHL, breast, ovarian CA. Immunosuppression. SEs: myelosuppression, Hem cystitis
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Uses of busulfan…
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CML and ablating bone marrow in stem cell transplants
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SEs of vincristine… vinblastine…
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Vincristine: neuroteoxicity, paralytic ileus. Vinblastine: Blast Bone marrow
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SEs of cisplatin/carboplatin…
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Nephrotoxcity, acoustic nerve damage
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Uses of hydroxyurea… SEs…
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Melanoma, CML, SCD (incr HbF). SEs: decr platelets and lymphos, GI upset
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Tamoxifen/ raloxifene MOA… SEs…
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E receptor antagonists in breast but agonists in bone. Tamoxifen may be agonist in endometrium and incr risk of endometrial CA; raloxifne is endometrial antagonist. Cause hot flashes
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Trastuzumab SE..
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Cardiotoxicity
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