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172 Cards in this Set

  • Front
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bleeding time range
2-9 min
incr circ if plts, >1000x 10^9
incr b.p.
excess thrombus formation
thrombocytosis
b.m. disorder
incr in plts due to clonal prolif
primary thrombocytosis
iron def
chroin inflam
splenctomy
after massive blood loss
secondary thrombocytosis
thrombocytosis assoc with what diseases
Hodgkins
PV
myelofibrosis
CML
20-40 yo
lasts months to years
>20000 plts
assoc with SLE, splenectomy, chemo
Chronic ITP
2-6 yo
2-6 weeks
80% spontaneous recovery
< 20000 plts
after virus
acute ITP
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
N results
<8 yo
HUS
N- test results
Adult/ W
TTP
incr PT and APTT
+ FDP and D DImer
schistocytes
DIC
3 qualitative plt disorders
adehsion, aggregation, secretion
Dohle bodies
decr PLT
MPB 15-20
May Hegglin
adhesion, abn lack of vWF receptor for GP Ib/IX/V
child hood
incr PLT size
ABN- Ristocetin
incr BT
B-S
purpura, bleeding form mucous memb
leads to renal failure
children
2nd to pregnancy, HIV, transplant
incr- BUN, creatinine, protein, heaturia
Burr Cells
HUS
pinpoint
petechiae
2mm-1cm
purpura
> 1cm
ecchymoses
caused by integrity of vessel, release of TF
> coag cascade
palpable
incr intrathoracic pressure of vessel
external
non palpable
Rubber man
hyperextension
large ecchymoses and hematomas
connective tissue effected
Ehlers Danlos
causes scurvy
decr aggregation
Vit C
bleeding from extremities
poor vessels
mc inherited blood disorder
on face/head, palms/soles
epistaxis and alimentary bleeding
HHT
symm leisions
in children
kidney/GI/CNS
ab and joint pain
Henoch Schonlein purpura
cold precip proteins in plasma
hemorrhage with palpable
Cryoglobulinemia
result of defect of fibrin conversion
Dysfibrinogenemia
> serine protease
inact of Va and VIIIa
ACP
accelerates activity of ATIII
most impt inhib of clotting factor
heparin
can neutralize proteases of intrinsic pathway
ATIII def
3 circ anti coags
APC
Protein S
Plasmin
mutation of Va
resistant to anticoag of APC
alters binding site
factor V leiden
what to do when APC-R pos
give anticoags
Coumadin
factors used during clotting
I
II
V
VIII
XIII
converts fibrinogen to fibrin
thrombin
intrinsic
PK
HMWK
Ca
XII
XI
IX
VIII
extrinsic
III
VII
V
common
X
V
II
I
Ca
doesnt usually lead to bleeding disorder
XII
HMWK
PK
XIII def
no clot formation
poor wound healing
mc inherited coag def
Hemophilia A
VIII def
sex linked
Men
incr APTT
N PT and BT
Hemophlilia A
receptor for plt adhesion
glycoprotein
vWF
bleeding
incr BT and APTT
decr in glycoprotein
vWF def
intrinsic =
APTT
extrinsic =
PT
PT range
10-13 s
heparin range
.2-.4
APTT range
<35 s
not detected by PT or APTT
XIII
plt defects
N APTT
incr PT
VII def
no intrinsic or common factors
uncontrolled clotting
leads to consumption of clotting factors and plts
leads to bleeding
DIC
incr PT and APTT most of the time
decr fibrinogen and plts
incr FDP and D Dimers
DIC
FDP pos
D Dimer neg
pathologic fibrinolysis
specific to ethnicity
defect in GP IIb/IIIa
cant bind fibrinogen
bruising, bleeding, menorrhagia
incr BT
Glanzmanns
dense body def
normal PLT count
incr BT
abn aggregation
epixstasis, purpura, meohorraghia, post surgery bleeding
Storage Pool disease
x lined
immune def
small plts
thrombocytopenia
eczema
Wiskott-Aldrich
albinism
recurrent inf
giant lysosomes
Chediak- Higashi
bleeding
decr fibrinogen
decr PT, APTT, TT
incr BT
abn plt aggregation
need infusion for life
Afibrinogenemia
abn fibrinogen molecule
abn deposits
defective aggregation
RT adn TT incr
Dysfibrinogenemia
I
Fibrinogen
II
Prothrombin
VII
correct with Russels venom
aged serum
bleeding
incr PT
VIII
Hemo A
female carrier
incr APTT
FVIII:C abscence
decr plt
incr PT and APTT
worse with aspirin
vWF
IX
Hemo B
incr APTT
correct with normal and aged
X
rare
incr Pt and APTT
correct with aged
RVV incr
XI
Adhkenazi Jews
incr APTT
anemia for AL
N/N
M0
undiff blasts
M1
almost all myeloblasts
with min maturation
M2
less than 90% myeloblasts
some mature cells
AUER RODS
mc AML
M3
APL
promyelocyte
M3M
APL
promyelocyte
microgranular variant
M4
AMML
myeolmonocyte
M4eo
AMML
with abn eos
M5a
AMoL
monocytic- differentiated
M5b
AMoL
monocytic- poor diff
M6
erythroid
AEL
M7
Megak
L1
homogenous
L2
heterogeneous
L3
Burkitt
Peroxidase
diff AML and ALL
in Neut and monos
pos = no ALL
SBB
diff AML and ALL
stains lipids in neut and monos
opp Peroxidase
PAS
diff ALL and AML
pos for RBC precursors
usually pos for ALL
auer rods in peroxidase stain =
AML
TdT
for primitave lymp cells
seen in ALL
also in CML
myeloid antigens
CD33 and CD13
B antigens
CD 19, 10, 22
T antigens
CD2, 3, 5, 7
Phil chromosome
CML
incr with leukemoid, PV, and pregnancy
decr with CML
LAP
fragile lymphs seen in CLL
smudge cells
TRAP pos
Hairy cell leukemia (CLL)
bone marrow filled with fibrous tissue
tear drops, NRBC, imm granulocytes
myelofibrosis
plasma cells replace normal bm cells
rouleaux
incr ESR
Multiple myeloma
malignant lymp-plasma cell prolif disorder with incr IgM
rouleaux
incr ESR
Waldenstroms macroglobulinemia
normal M:E
< 4:1
plasma cell cancer
> 40
Bence JOnes
incr Ca
M spike
Multiple Myeloma
liver spleen l.n.
elderly
Gamma HCD IgG
abdominal mass- GI
younger, Mediterranean
ALpha HCD IgA
CLL assoc
MU HCD IgM
Acquired immuno def syndrome
RNA virus
depletion of CD4+ cells
HIV
Myelodysplastic synds
RA
RARS
RAEB
RAEBIT
CMML
Myeolprolif disorders
CML
PV
ET
alpha Naphtyhly Acetate Esterase
diffs neuto precursors from monos in AL
PAS
for LL
Acid Phos Cytochem Stain
Hairy cell
mostly hypercellular bm
RS
CMML
Myelodysplastic synd
mc LL
children
L1 and L2
< 100000/L
B cell ALL
L1,2,3
> 100000/L
T cell ALL
mc LL in adults
B cell neoplasm
NC/NC anemia
CLL
prolymphs in periph blood
> 100x 10^p WBC
splenomegaly
B-prolymph leukemia
nodal counter part of CLL
non H lymphoma
looks like CLL
Small LL
non H, with B cells
CD5-
clefts/folded nucleuses
Small cleaved cell lymphoma
B lymph
projections
with pancytopenia
ACid Phos +
Hairy Cell leukemia
leukemic phase of cutaneous T cell lymphoma
mycosis fungoides
Sezary synd
caused by HTLV-1
clover nucleus
anisocytosis
Adult T cell Lymphoma
prolif of benign inflam cells with malignant cells
mc malig of children
with 1 firm node, that spreads
must have RS cells
Hodgkins lymphoma
more common
20-40 yo
from periphreal ln
Non H lymphoma
anemia
decr monos

only erythroid dysplasia
RA
anemai
decr monos

erythroid dysplasia
with >15% RS
RARS
Bi/pancytopenia
decr monos

dysplasia in 2 lines
RCMD
Bi/pancytopenia
decr monos

dysplasia in 2 cell lines
RS
RCMD-RS
cytopenia
decr monos

multilineage dysplasia
some blasts
RAEB1
cytopenia
blasts and AR

blasts and AR
RAEB2
cytopenia

unilineage dysplasia
MDU-S
HCT x 10 / RBC
MCV
Hgb x 10 / RBC
MCH
Hgb x 100 / HCT
MCHC
MCV
80-96
MCH
27-32
MCHC
32-36
RDW
11-15
HGB-M
14-18
HGB-F
12-16
migration on cellulose acetate
A, F, A2, C
citrate agar migration
C,S,A,A2,F
HgbS
valine subs for glutamic acid on 6th position of Beta chain
HgbC
lysine subs for glutamic acid on 6th position of Beta chain
microcytic hypochromic
normal RDW
incr Hgb A2
B thal minor
microcytic hypochromic
incr HgbA
target cells and basophilic ctippling
B thal major
decr iron
incr TIBC
decr %sat
decr ferritin
incr- RDW
IDA
incr Iron
N- decr TIBC
incr %sat
incr Ferritin
HA
N-decr Iron
decr TIBC
Pernicious Anemia
N- incr Iron
N- decr TIBC
N-incr %sat
N- incr Ferritin
B thal
incr serum iron
decr TIBC
N-RDW
Anemia Chronic Disease
for iron stores
serum ferritn
serum iron
50-150
tibc
250-400
ferritin
15-200
decr in Hgb, HCT, MCV
hypochromic/microcytic
IDA
ovalocytes, hyperseg, anisocytosis
leukopenia and thrombocytopenia
B 12 def
PA
incr MCHC
herditary spherocytosis
HA
Heinz bodies
mc rbc enzyme disorder
bite cells
g-6-PD def
Hams test
sus. to lysis
hemosiderinuria
young adults
PNH
pancytopenia
decr retics
Aplastic anemia
mc EM pathway def.
mild-mod anemia
splenomegaly
jaundice
incr fluroescence
PK def
mc cause of aplastic anemia
idiopathic
congenital form of AA
bm transplant
Fanconis Anemia
erythrocyte aplasia in young children
no leukopenia or thrombocytopenia
Diamond Blackfan
-/aa Alpha thal
in ASians
-a/-a Alpha thal
in Africans
decr MCV
Alpha Thal
gamma tetramers
4 gamma chains
Hb Barts
Beta tetramers
4 beta chains
Hgb H
--/-a
Hgb H
cellulose acetate agar
towards anode
alkaline
ovalocytes
hyperseg
pancytopenia
decr retics
Incr LDH
decr B12
incr MCV
bm- giant bands and metamyelocytes
Megaloblastic Anemia
pos Coombs test
retics
decr RBC life
Immuno-hemolytic anemia
IgG coat rbc
jaundice- incr bili
normal RBC indicies
fragile spherocytes
Warm AHA
IgM
cold
can be from EBV
>50 yo
I/i
incr bili
dark urine
DAt +
Cold AHA