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