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78 Cards in this Set

  • Front
  • Back
• What’s the formula for ANC?
o Total WBC x (% segs + % bands)
• What’re the ranges?
o < 500 = severe neutropenia
o 500-1000 = moderate neutropenia
o 1000-1500 = mild neutropenia
• What is the adult CBC differential? (NLMEB)
o Bands (0-4), Segs (47-63), Monocytes (4-9), Lymphocytes (24-40), Eosinophils (0-3), Basophils (0-2)
• What’s the leuokocyte count normally?
• How many segs does a mature neutrophil usually have?
• Neutrophil maturation, goes from?
Myeloblast→ metamyelocyte→ band→ seg
• If you see bands, what’s it mean?
Likely a bacterial infection, inflam disease, tiss damage, BM malignancy
• What if you’re neutropenic?
Viral infection, drugs, newborn sepsis
• When you see high no.’s of eos’s, what do you expect?
Wheezes, worms, weird dieases -In response to IgE (allergic) or IgA (paracites)
• What do basophils do?
Release histamine in type I hypersentativities
• What are they called in the skin & respiratory mucosa?
mast cells
• What do monocytes do?
Respond to bact., viral infections, chronic inflammatory diseases. They’re phagocytic, and mature into macrophages in the tissue
• Lymphocytes are from the bone marrow & are part of the:
o Adaptive immune response (recognize self; historians)
• Where do T lymphocytes mature?
where do B lymphocytes mature?
bone marrow
• What regulates RBC production?
Tissue oxygenation & renal erythropoietin
• What’re the normal values for a CBC?
o Hgb: 12-15 g/dL (females) & 14-17 g/dL (males)
o Plt: 150-300,000
o Hct: 45%
o WBC: 4500-17,000/mm3
• What stimulates platelet production?
o Cytokines- thrombopoietin
• What are the plasma proteins:
albumin, globulins, fibrinogen
• What are symptoms of tissue hypoxia?
o Pallor, weakness, fatigue, claudication, dizziness, incr. respiratory rate
• What are the manifestations of anemia?
o CV: increasesd card output, fluids into intravasc space, Incr. RR, Hgb releases O2 easier, incr. erythropoietin
• What are the macrocytic-normochromic anemias?
o Pernicious (lack of B12 fro RBC prod)
o Folate deficiency (need it for “ “ )
• What are the microcytic-hypochromic anemias?
o Iron-deficient (for Hgb prod) o Sideroblastic (dysfunctional Iron uptake by RBCs)
o Thalassemia (impaired synth. Of Hgb chains)
• What are the normocytic-normochromic anemias?
o Sickle cell disease (abnormal Hgb synth, abnormal shape)
o Aplastic (insufficient erythropoiesis)
o Post-hemorrhagic
o Hemolytic (premature destruction of RBCs)
o Anemia of chronic disease
• What might cause decreased RBC production?
o Aplastic anemia, RBC aplasia, malignancies, anemia of chronic disease, lead poisoning, nutritional anemias, thalassemia
• What about increased RBC destruction?
o Sickle cell, hereditary spherocytosis, G6PD deficiency,
• What’s the most common anemia world wide? Iron deficient
o Near normal RBC count, low Hgb, microcytic, hypochromic, poikilocytois, anisocytosis.
• What’s the most common genetic disease worldwide?
o Thalassemia ( Hgb chains ∅ synthesize correctly)
• Explain what Heinz bodies are?
o When there is beta-thalassemia, the alpha chain continues to be made & accumulates, denaturing into Heinz bodies, which impair DNA synth & damage the cell membrane (severely hypochromic, microcytic)
What would cause neutropenia?
-radiation, drug induced, viral infections (CMV, parvovius), congenital- decrease production
- incr. destruction: isoimmune neonatal, autoimune, splenic sequestration
Which leukemia is most common in childhood?
Acute lyphocytic leukemia (ALL)
Which leukemia peaks between 13-19 years of age?
Acute myelocytic leukemia (AML)
Which leukemia affects mainly older adults?
Chronic lymphocytic leukemia (CLL)
Which leukemia peaks between 30 & 50 years of age?
Chronic myelocytic leukemia (CML)
These places act as nests for future bone marrow relaps
sanctuary sites (CNS, Testes)
What can cause acquired coagulation disorders?
Vitamin K deficiency (decreased levels of Factors) & liver disease
what hereditary disorders cause bleeding disorders
Hemophilia A & B, Von Willebrand disease
What's the most common inhereted disease of severe bleeding?
the x-linked recessive disease, Hemophilia A (involves reduced Factor VIII)
What is Christmas disease?
Hemophila B, a Factor IX deficiency. Also x=linked recessive
What is a platelet count of less than 100,000?
what causes thrombocytopenia?
decreased plt production, decreased plt survival, sequestration, HIV
What does ITP stand for?
immune thrombocytopenia purpura; accel. plt desttruction (mediated by autoantibodies)
What is DIC?
Disseminated Intravascular Coagulation; not a disease, but symptom of underlying problem
What are the components of whole blood?
RBCs, granulocytes, platelets & plasma
What does blood plasma contain?
plasma proteins, Ig's , complement, coagulation Factos, albumin
what type of immunological rxns can occur?
acute hemolytic, delayed hemolytic, febrile, allergic, anaphylactic (IgA?)
whate are the 2 types of blood progenitor cells?
myeloid (RBC, plt, baso, eosin, granulocyte precursor) & Lymphoid (B & T lymphocyte precursor)
what is the name of the disease in which there is pure red blood cell aplasia?
Blackfan-Diamond Disease
What's the name of WBCc aplasia?
Kostmann's Disease
If the hemoglobin is 15, what is the hematocrit (roughly)?
45: Hematocrit =3 x's the Hgb
What do you need in your stomach to absorb B12?
Intrinsic factor (IF)- b/c B12 needed to produce RBCs
What are the primary lymph organs?
thymus, bursa & bone marrow
what are the secondary lymph organs?
spleen, lymph nodes, lymphoid tissue (gut, mucosa, & broncial associated lymphoid tissues)
self-antigens that do not stimulate a response are?
this group of plasma proteins provides protection against non-capuslar bacteria, large viruses, & intracellular organisms
what does lactoferrin do, and where's it come from?
binds iron & vitamin B12, which are both needed for cell growth. Released by phagocytes
this is a chronic inflammation triggered by persistent infectinos agents.
granuloma (central area of macrophages surrounded by T cells)
what are some of the roles complement plays?
causes mast cells to release histamine, is chemotactic, activates macrophages, makes it easier to be phagocytosed (opsonization "tags" cells for destruction), transports immune complexes & lysis of cells
what is the difference b/n humoral & cellular immunity?
humoral = b-cells, producing AB's
Cellular = t-cells
Talk about cellular immunity
T lymphocytes, CD 4 ("helper T cells")- direct cellular responses & CD 8 (cytotoxic t-cells) destroy infected cells
what does MHC stand for?
major histocompatibility complex: part of the genome that makes your HLA (human lymphocyte antigen)
What class of HLA do CD8's recognize & kill?
class 1
What class of HLA do CD4's recognize & cause to pour out cytokines which trigger other cells (macrophages, activated t-celss, etc.)?
Class II
How does HIV work?
Kills CD4 cells w/ all associated problems related to lack of coordination of inflammatory process
walk thru basic immune activation
Helper T cells proliferate, inflam cytokines released: IL1 is a pyrogen factor, as is TNF. IL6 stimulates B cells in the plasma to make AB's. It also activates C reactive protein & fibrinogen to localize the infection. IL-2 & IFN gamma are cytokines that stimulate CD8 cells
what type of disease is DiGeorge Syndrom?
congenital thymic aplasia or hypoplasia. Fewer t cells increases risk of infection
What are the functions of antibodies?
opsonization , immobilie flagella & cilia, compete for binding sites, blocks toxins
What is SCID?
Severe combined immunodeficiency- absence of B & T cell function from birth
what is wiskott-aldrich syndrom?
x-linked recessive triad of recurrent bact & viral inf's, bleeding/thrombocytopenia, eczema
Type I Hypersensitivity:
IgE--> true allergic rxn. Immediate. Allergen interacts w/ IgE sensitized mast cell or basophil (has Fc receptors), releasing histamine (degranulation)
ex. of Type I hypersensitivity
allergy, asthma, anaphyaxis, urticaria (hives)
Type II Hypersensitivity, examples:
IgG mediated, cytotoxic. IgG binds to surface antigen on target, neutrophils can't phagocytose properly, releassinng killing enzymes damaging self cells. Eg. Rh-
Type III Hypersensitivity
Immune compleses normally removed by complement & phagocytes. overproduction & deposition in tissues. Complement causes local imlfm. eg: acute glomerulonephritis & serum sickness.
Type IV hypersensitivity
Antigen stimulates normal t cell response, but not a true allergy! eg. insext venum, TB, metals, gluten-sensitivity in bowel
what's a hapten?
antigens, such as nickel, chromate, rubber, latex, that combines w/ epidermal proteins to become an antigen. eg. ppd, contact dermatitis
Name the 4 types of hypersentisity & autoimmunity diseases
Type I (IgE mediated autimmunity)- rare
Type II (Cytotoxic): autoimmunehemolytic anemia
Type III (immune complex): Systemic lupus
Type IV (Delayed): Poison ivy
when mature T cells from a graft recognize the host, tend to see systemic disease. Often a problem w/ bone marrow transplants
Graft vs. host
When mature host T cell recognizes graft, more common in organ transplants & causes organ failure
host. vs. graft