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172 Cards in this Set
- Front
- Back
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bleeding time range
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2-9 min
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incr circ if plts, >1000x 10^9
incr b.p. excess thrombus formation |
thrombocytosis
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b.m. disorder
incr in plts due to clonal prolif |
primary thrombocytosis
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iron def
chroin inflam splenctomy after massive blood loss |
secondary thrombocytosis
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thrombocytosis assoc with what diseases
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Hodgkins
PV myelofibrosis CML |
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20-40 yo
lasts months to years >20000 plts assoc with SLE, splenectomy, chemo |
Chronic ITP
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2-6 yo
2-6 weeks 80% spontaneous recovery < 20000 plts after virus |
acute ITP
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excessive deposit of plt aggregates in renal/cerebral tissue
3x in W, ~35 yo PT,APTT, and Fibrinogen- N incr. plt agg. factor and decr in PGI2 FDP + |
TTP
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N results
<8 yo |
HUS
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N- test results
Adult/ W |
TTP
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incr PT and APTT
+ FDP and D DImer schistocytes |
DIC
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3 qualitative plt disorders
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adehsion, aggregation, secretion
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Dohle bodies
decr PLT MPB 15-20 |
May Hegglin
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adhesion, abn lack of vWF receptor for GP Ib/IX/V
child hood incr PLT size ABN- Ristocetin incr BT |
B-S
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purpura, bleeding form mucous memb
leads to renal failure children 2nd to pregnancy, HIV, transplant incr- BUN, creatinine, protein, heaturia Burr Cells |
HUS
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pinpoint
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petechiae
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2mm-1cm
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purpura
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> 1cm
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ecchymoses
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caused by integrity of vessel, release of TF
> coag cascade |
palpable
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incr intrathoracic pressure of vessel
external |
non palpable
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Rubber man
hyperextension large ecchymoses and hematomas connective tissue effected |
Ehlers Danlos
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causes scurvy
decr aggregation |
Vit C
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bleeding from extremities
poor vessels mc inherited blood disorder on face/head, palms/soles epistaxis and alimentary bleeding |
HHT
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symm leisions
in children kidney/GI/CNS ab and joint pain |
Henoch Schonlein purpura
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cold precip proteins in plasma
hemorrhage with palpable |
Cryoglobulinemia
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result of defect of fibrin conversion
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Dysfibrinogenemia
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> serine protease
inact of Va and VIIIa |
ACP
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accelerates activity of ATIII
most impt inhib of clotting factor |
heparin
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can neutralize proteases of intrinsic pathway
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ATIII def
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3 circ anti coags
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APC
Protein S Plasmin |
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mutation of Va
resistant to anticoag of APC alters binding site |
factor V leiden
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what to do when APC-R pos
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give anticoags
Coumadin |
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factors used during clotting
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I
II V VIII XIII |
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converts fibrinogen to fibrin
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thrombin
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intrinsic
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PK
HMWK Ca XII XI IX VIII |
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extrinsic
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III
VII V |
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common
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X
V II I Ca |
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doesnt usually lead to bleeding disorder
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XII
HMWK PK |
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XIII def
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no clot formation
poor wound healing |
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mc inherited coag def
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Hemophilia A
VIII def |
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sex linked
Men incr APTT N PT and BT |
Hemophlilia A
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receptor for plt adhesion
glycoprotein |
vWF
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bleeding
incr BT and APTT decr in glycoprotein |
vWF def
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intrinsic =
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APTT
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extrinsic =
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PT
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PT range
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10-13 s
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heparin range
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.2-.4
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APTT range
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<35 s
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not detected by PT or APTT
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XIII
plt defects |
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N APTT
incr PT |
VII def
no intrinsic or common factors |
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uncontrolled clotting
leads to consumption of clotting factors and plts leads to bleeding |
DIC
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incr PT and APTT most of the time
decr fibrinogen and plts incr FDP and D Dimers |
DIC
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FDP pos
D Dimer neg |
pathologic fibrinolysis
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specific to ethnicity
defect in GP IIb/IIIa cant bind fibrinogen bruising, bleeding, menorrhagia incr BT |
Glanzmanns
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dense body def
normal PLT count incr BT abn aggregation epixstasis, purpura, meohorraghia, post surgery bleeding |
Storage Pool disease
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x lined
immune def small plts thrombocytopenia eczema |
Wiskott-Aldrich
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albinism
recurrent inf giant lysosomes |
Chediak- Higashi
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bleeding
decr fibrinogen decr PT, APTT, TT incr BT abn plt aggregation need infusion for life |
Afibrinogenemia
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abn fibrinogen molecule
abn deposits defective aggregation RT adn TT incr |
Dysfibrinogenemia
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I
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Fibrinogen
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II
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Prothrombin
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VII
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correct with Russels venom
aged serum bleeding incr PT |
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VIII
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Hemo A
female carrier incr APTT FVIII:C abscence |
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decr plt
incr PT and APTT worse with aspirin |
vWF
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IX
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Hemo B
incr APTT correct with normal and aged |
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X
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rare
incr Pt and APTT correct with aged RVV incr |
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XI
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Adhkenazi Jews
incr APTT |
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anemia for AL
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N/N
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M0
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undiff blasts
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M1
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almost all myeloblasts
with min maturation |
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M2
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less than 90% myeloblasts
some mature cells AUER RODS mc AML |
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M3
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APL
promyelocyte |
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M3M
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APL
promyelocyte microgranular variant |
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M4
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AMML
myeolmonocyte |
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M4eo
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AMML
with abn eos |
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M5a
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AMoL
monocytic- differentiated |
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M5b
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AMoL
monocytic- poor diff |
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M6
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erythroid
AEL |
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M7
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Megak
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L1
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homogenous
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L2
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heterogeneous
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L3
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Burkitt
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Peroxidase
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diff AML and ALL
in Neut and monos pos = no ALL |
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SBB
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diff AML and ALL
stains lipids in neut and monos opp Peroxidase |
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PAS
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diff ALL and AML
pos for RBC precursors usually pos for ALL |
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auer rods in peroxidase stain =
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AML
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TdT
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for primitave lymp cells
seen in ALL also in CML |
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myeloid antigens
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CD33 and CD13
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B antigens
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CD 19, 10, 22
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T antigens
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CD2, 3, 5, 7
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Phil chromosome
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CML
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incr with leukemoid, PV, and pregnancy
decr with CML |
LAP
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fragile lymphs seen in CLL
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smudge cells
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TRAP pos
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Hairy cell leukemia (CLL)
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bone marrow filled with fibrous tissue
tear drops, NRBC, imm granulocytes |
myelofibrosis
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plasma cells replace normal bm cells
rouleaux incr ESR |
Multiple myeloma
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malignant lymp-plasma cell prolif disorder with incr IgM
rouleaux incr ESR |
Waldenstroms macroglobulinemia
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normal M:E
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< 4:1
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plasma cell cancer
> 40 Bence JOnes incr Ca M spike |
Multiple Myeloma
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liver spleen l.n.
elderly |
Gamma HCD IgG
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abdominal mass- GI
younger, Mediterranean |
ALpha HCD IgA
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CLL assoc
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MU HCD IgM
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Acquired immuno def syndrome
RNA virus depletion of CD4+ cells |
HIV
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Myelodysplastic synds
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RA
RARS RAEB RAEBIT CMML |
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Myeolprolif disorders
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CML
PV ET |
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alpha Naphtyhly Acetate Esterase
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diffs neuto precursors from monos in AL
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PAS
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for LL
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Acid Phos Cytochem Stain
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Hairy cell
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mostly hypercellular bm
RS CMML |
Myelodysplastic synd
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mc LL
children L1 and L2 < 100000/L |
B cell ALL
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L1,2,3
> 100000/L |
T cell ALL
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mc LL in adults
B cell neoplasm NC/NC anemia |
CLL
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prolymphs in periph blood
> 100x 10^p WBC splenomegaly |
B-prolymph leukemia
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nodal counter part of CLL
non H lymphoma looks like CLL |
Small LL
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non H, with B cells
CD5- clefts/folded nucleuses |
Small cleaved cell lymphoma
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B lymph
projections with pancytopenia ACid Phos + |
Hairy Cell leukemia
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leukemic phase of cutaneous T cell lymphoma
mycosis fungoides |
Sezary synd
|
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caused by HTLV-1
clover nucleus anisocytosis |
Adult T cell Lymphoma
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prolif of benign inflam cells with malignant cells
mc malig of children with 1 firm node, that spreads must have RS cells |
Hodgkins lymphoma
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more common
20-40 yo from periphreal ln |
Non H lymphoma
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anemia
decr monos only erythroid dysplasia |
RA
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anemai
decr monos erythroid dysplasia with >15% RS |
RARS
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Bi/pancytopenia
decr monos dysplasia in 2 lines |
RCMD
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Bi/pancytopenia
decr monos dysplasia in 2 cell lines RS |
RCMD-RS
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cytopenia
decr monos multilineage dysplasia some blasts |
RAEB1
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cytopenia
blasts and AR blasts and AR |
RAEB2
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cytopenia
unilineage dysplasia |
MDU-S
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HCT x 10 / RBC
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MCV
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Hgb x 10 / RBC
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MCH
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Hgb x 100 / HCT
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MCHC
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MCV
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80-96
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MCH
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27-32
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MCHC
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32-36
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RDW
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11-15
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HGB-M
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14-18
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HGB-F
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12-16
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migration on cellulose acetate
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A, F, A2, C
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citrate agar migration
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C,S,A,A2,F
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HgbS
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valine subs for glutamic acid on 6th position of Beta chain
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HgbC
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lysine subs for glutamic acid on 6th position of Beta chain
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microcytic hypochromic
normal RDW incr Hgb A2 |
B thal minor
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microcytic hypochromic
incr HgbA target cells and basophilic ctippling |
B thal major
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decr iron
incr TIBC decr %sat decr ferritin incr- RDW |
IDA
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incr Iron
N- decr TIBC incr %sat incr Ferritin |
HA
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N-decr Iron
decr TIBC |
Pernicious Anemia
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N- incr Iron
N- decr TIBC N-incr %sat N- incr Ferritin |
B thal
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incr serum iron
decr TIBC N-RDW |
Anemia Chronic Disease
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for iron stores
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serum ferritn
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serum iron
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50-150
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tibc
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250-400
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ferritin
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15-200
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decr in Hgb, HCT, MCV
hypochromic/microcytic |
IDA
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ovalocytes, hyperseg, anisocytosis
leukopenia and thrombocytopenia B 12 def |
PA
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incr MCHC
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herditary spherocytosis
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HA
Heinz bodies mc rbc enzyme disorder bite cells |
g-6-PD def
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Hams test
sus. to lysis hemosiderinuria young adults |
PNH
|
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pancytopenia
decr retics |
Aplastic anemia
|
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mc EM pathway def.
mild-mod anemia splenomegaly jaundice incr fluroescence |
PK def
|
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mc cause of aplastic anemia
|
idiopathic
|
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congenital form of AA
bm transplant |
Fanconis Anemia
|
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erythrocyte aplasia in young children
no leukopenia or thrombocytopenia |
Diamond Blackfan
|
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-/aa Alpha thal
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in ASians
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-a/-a Alpha thal
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in Africans
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decr MCV
|
Alpha Thal
|
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gamma tetramers
4 gamma chains |
Hb Barts
|
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Beta tetramers
4 beta chains |
Hgb H
|
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--/-a
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Hgb H
|
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cellulose acetate agar
|
towards anode
alkaline |
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ovalocytes
hyperseg pancytopenia decr retics Incr LDH decr B12 incr MCV bm- giant bands and metamyelocytes |
Megaloblastic Anemia
|
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pos Coombs test
retics decr RBC life |
Immuno-hemolytic anemia
|
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IgG coat rbc
jaundice- incr bili normal RBC indicies fragile spherocytes |
Warm AHA
|
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IgM
cold can be from EBV >50 yo I/i incr bili dark urine DAt + |
Cold AHA
|
