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69 Cards in this Set
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- Back
- 3rd side (hint)
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hypersegmented neutrophils?
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megaloblastic anemia (vit B12 or folate deficiency(
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what are macrophages activated by?
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gamma interferon
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marker for macrophages?
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CD14
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five causes of eosinophilia?
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NAACP: Neoplastic, Asthma, Allergic processes, Collagen vascular diseases, Parasite (helminths)
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what prevents mast cell degranulation (thus used for asthma prophylaxis)?
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Cromolyn sodium
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why do anti-AB antibodies not cross the placenta but anti-Rh do?
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Anti Rh are IgG
Anti AB are IgM |
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what does antithrombin inactivate and what activates it?
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Activated by heparin;
Inactivates thrombin, and factors 7, 9,10, 11, and 12 |
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What does warfarin inhibit? what is marker of this?
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epoxide reductase, therefore same symptoms as vit K deficiency: less factor 2, 7, 9, 10, C and S
Increase PT |
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name the 5 players in anti-coagulation?
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Protein C, Protein S, tPa, plasminogen (becomes plasmin) and antithrombin
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explain how aspirin, ticlopidine/clopidogrel and abciximab all prevent clotting?
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Aspirin: COX inhibitor thus lowering thromboxane
Clopidogrel: inhibits ADP-induced expression of GpIIb/IIIa Abciximab: inhibits GpIIb/IIIa directly |
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what 5 conditions elevate the ESR?
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1) infections
2) inflammatory dz (temporal arteritis) 3) malignant neoplasms 4) GI dz (UC) 5) pregnancy |
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what 5 conditions lower the ESR?
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1) polycythemia
2) sickle cell anemia 3) CHF 4) microcytosis 5) hypofibrinogenemia |
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acanthocytes (spur cells)?
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liver disease and abetalipoproteinemia
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basophilic stippling?
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TAIL: thalassemias, Anemia of chronic disease, Iron deficiency, Lead poisoning
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bite cell?
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G6PD (due to heinz body removal)
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Macro-ovalocyte
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megaloblastic anemia
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schistocyte (helmut cell)
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DIC, TTP/HUS, traumatic hemolysis (valve replacement)
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teardrop cell
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bone marrow infiltration (myelofibrosis)
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target cell
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HALT! HbC disease, Asplenia, Liver disease, Thalassemia
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Heinz bodies
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alpha thalassemia and G6PD (due to oxidation of iron to ferric form which denatures hemoglobin/precipitates it)
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Howell-jolly bodies
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Asplenia (or hyposplenia)
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What do 3 and 4 gene deletions cause in alpha thalassemia?
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3: HbH (B4 tetramers)
4: Hb Barts (hydrops fetalis) |
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4 causes of microcytic anemia?
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thalassemia, sideroblastic anemia (lead poisoning), anemia of chronic disease, and iron deficiency anemia
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What type of Hb is raised in B thal major and minor? what is raised in just minor?
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More HbF in both
HbA2 is >3.5% in minor |
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anisocytosis, poiklocytosis, microcytosis, target cells and schistocytes
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B thalassemia
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What does lead inhibit?
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ferrocheletase and ALAD (also rRNA degradation) THUS decreasing heme sy
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lead poisoning neumonic?
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Lead lines on gingiva and long bone x-ray
Encencephalopathy Abdominal colic Drops (wrist and foot); eDta and Dimercaprol are treatment Succimer is treatment for kids |
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List the types of sideroblastic anemia? what is the underlying cause for them?
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Defect in heme synthesis:
Hereditary: X-linked defect in ALAS Alcohol, lead |
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treatment for sideroblastic anemia?
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Vitamin B6
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HbA
HbA2 HbF HbBarts HbH |
A: 2 alpha, 2 beta
a2: 2 alpha, 2 delta F: 2 alpha, 2 gamma Barts: 4 gamma H: 4 beta |
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low grade fever, night sweats, weight loss
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B symptoms (of Hodgkin's lymphoma)
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mediastinal lymphadenopathy?
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Hodgkin's
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sheets of lymphocytes with interspersed macrophages; associated with EBV
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Burkitt's lymphoma
translocation? |
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most common adult NHL?
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Diffuse large B-cell lymphoma
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CD 5+
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Mantle Cell lymphoma
demographic? prognosis? genetics? |
older male
bad prognosis t(11,14) inactivating cyclin D |
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t(14,18)
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follicular lymphoma
genetics? |
more bcl-2 expression
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how do T cell lymphomas often present?
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cutaneous nodules
(Adult T-cell lymphoma and mycosis fungoides) |
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fried egg appearance
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multiple myeloma
syptoms? |
CRAB: Hypercalcemia, Renal Failure, Anemia, Bone lytic lesions, back pain
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clockface chromatin and intracytoplasmic inclusions
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multiple myeloma
what other things seen? |
infection, amyloidosis, punched out lesions of bone and skull, bence jone proteinuria, roleaux formation
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what are the M spike in mult myeloma?
Waldenstrom's macroglobulinemia? |
MM: IgG or IgA (less)
WM: IgM so hyperviscosity no lytic lesions |
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Tdt+; bone marrow replacement by LOTS of lymphoblasts
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ALL (seen in kids under 15)
which type has a better prognosis? |
t(12,21)
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mature tumor in elderly with filamentous projections
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Hairy cell leukemia
stain? |
TRAP positive
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65 year old with smudge cells in peripheral blood + warm antibody autoimmune hemolytic anemia
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CLL
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increased myeloblasts and Auer rods
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AML age (15-59)
common presentation? |
DIC
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t (15,17)
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AML (m3 subtype)
responds to what treatment? |
all-trans retinioic acid
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increased neutrophils, metamyelocytes, basophils and splenomegaly and low alk phos
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philly chromosome in CML (bcr-abl) 9,22 translocation
responds to ? |
gleevec (imantinib)
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peroxidase positive cytoplasmic inclusions in granulocytes and myeloblasts; can lead to DIC
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Auer Rods (seen in AML)
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S-100 and CD1a
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Langerhans cell histiocytosies
what do you see? |
Birbeck Granules (tennis rackets)
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teardrop cell
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fibrotic obliteration of bone marrow
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what mutation is associated with polycythemia vera, essential thrombocytosis, and myelofibrosis, but no CML
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JAK-2 mutations
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what conditions lead to appopriate absolute polycythemia (high RBC mass/low o2)?
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high altitude, lung disease, congenital heart dz
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what conditions lead to inappropriate absolute (high RBC mass for no reason)
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RCC, Wilm's Tumor, cyst, HCC, hydronephrosis
due to what? |
ectopic Erythopoetin
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decreased haptoglobin, inc. LDH, hemoglobin in urine
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intravascular hemolysis
due to? |
PNH, mechanical destruction
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inc LDH, increased UCB causing jaundice
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extravascular hemolysis
due to? |
sickle cell, hereditary spherocytosis, g6PD def
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pancytopenia, hypocellular bone marrow with fatty infiltrate: fatigue, malaise, pallor, purpura, mucosal bleeding, etic
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aplastic anemia
due to: |
1)drugs
2) virus (parvo B19, EBV, HIV, HCV) 3) Fanconi's anemia 4) Idiopathic |
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impaired GPI anchor/DAF leading to complement mediated RBC lysis
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PNH
lab? |
increase urine hemosiderin
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sickle cell mutation?
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glutamic acid to valine in B chain at position 6
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complications of sickle cells
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1) aplastic anemia (parvo B19)
2) autosplenectomy 3) salmonella osteomyelitis 4) renal papillary necrosis 5) painful crisis/dactylitis |
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Direct coomb's test?
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anti IgG added to pts RBC's agglutinate the RBCs if they are coated with Ig
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Indirect Coomb's test
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normal RBCs added to pts serum aggultinate if serum has anti-RBC surface Ig
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RBCs damaged when passing thru obstucted vessel lumen?
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microangiopathic anemia
examples? |
DIC, TTP-HUS, SLE, artherosclerosis
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what do transferrin and ferritin do?
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Transferrin: transports Fe in blood
Ferritin: stores Fe |
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Iron: Low
TIBC: High % saturation: low Ferretin: Low |
Iron Deficiency Anemia
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Iron: Low
TIBC: Low % saturation: Low Ferretin:High |
anemia of chronic disease
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Iron: high
TIBC: low % saturation: high Ferretin: High |
hemochromatosis
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tea colored urine and blistering cutaneous photosensitivity
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porphyria cutanea tarda (MC one)
defect? accumulates? |
uroporphyrinogen decarboxylase
uroporphyrin |
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red wine colored urine, painful abdomen, polyneuropathy, precipitated by drugs
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acute intermittent porphyria
defect accumulates treatment |
def: porphobilinogen deaminase
acc: porphobilinogen, delta-ALA, uroporphyrin treat: glucose and heme |
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microcytic anemia, GI and kidney disease
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lead poisoning
affected enzyme accumulates? |
ferrocheletase and ALAD
protoporphyrin |
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deficiency of ADAMTS 13 leading to large vWF multimers
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TTP
symptoms? |
pentad of: neurologic, renal, fever, thrombocytopenia and microangiopathic hemolytic anemia
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