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168 Cards in this Set
- Front
- Back
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What is a neutrophil?
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The phagocyte (anti-microbial, most abundant)
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What is an eosinophil?
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The parasite destroyer, allergy inducer
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What is a basophil?
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The allergy helper (IgE receptor--> Histamine release)
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What is a monocyte?
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The destroyer --> myeloperoxidase (coffee bean nucleus)
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What is a lymphocyte?
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The warriors (T, B, NK cells)
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What is a platelet?
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No nuclei, makes clot, smallest cell
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What is a blast?
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baby hematopoietic cell
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What is a band?
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baby neutrophil
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What does high WBC and high PMNs tell you?
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Stress demargination
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What does high WBC and <5% blasts tell you?
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Leukemoid rxn, seen in burn patients. Extreme demargination, looks like leukemia
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What does high WBC and >5% blasts tell you?
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Leukemia
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What does high WBC and bands tell you?
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Left, infection
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What does high WBC and B cells tell you?
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Bacterial infection
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What diseases have high eosinophils?
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"NAACP"
Neoplasm Allergy/Asthma Addison's disease (no cortisol -->relative eosinophilia) Collagen vascular disease Parasites |
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What diseases have high monocytes?
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"STELS"
Syphilis TB EBV Listeria Salmonella |
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What do high reticulocytes tell you?
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RBC being destroyed peripherally
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What do low reticulocytes tell you?
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Bone marrow not responding (decreased production)
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What is poikilocytosis?
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Different shapes
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What is anisocytosis?
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Different sizes
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What is the RBC lifespan?
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120 days
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What is te platelet lifespan?
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7 days
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What does -penia mean?
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Low levels, usually due to virus or drug
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What does cytosis mean?
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High levels
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What does cythemia mean?
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High levels
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What is the difference between plasma and serum?
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Plasma: no RBC
Serum: no RBC or fibrinogen |
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What is chronic granulomatous disease?
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NADPH oxidase deficiency
Recurrent staph/aspergillus infection Nitroblue tetraxolium stain negative |
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What does MPO deficiency cause?
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Catalase + Infections
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What is Chediak Highashi?
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Lazy leukocyte syndrome
Lysosomes are slow to fuse around bacteria |
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What organ can make RBCs if the long bones are damaged?
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Spleen
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What causes a shift to the right in the Hb curve?
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"all CADETs face right"
Increase CO2 Acid/Altitude 2,3 DPG Exercise Temperature |
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How does CO poison Hb?
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Competitive inhibitor of O2 on Hb
Cherry red lips, pinkish skin hue |
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How does cyaide poison Hb?
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Non-competitive inhibitor of O2 on Hb
Cyanotic Almond breath |
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What is MetHb?
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Hb w/ Fe3+
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What is acute intermittent porpyria?
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Increased: Porphyrin, urin d-ala, porphobilinogn
Abdominal pain, neuropathy, red urine |
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What is porphyria cutanea tarda?
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Sunlight --> Skin blisters due to porphyrin deposits
Woods lamp: orange-pink |
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What is erythrocytic protoporphyria?
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Porphyria cutanea tarda in a baby
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Sickle Cell Disease Mutation
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Beta Glu6-->Val
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What is HbC disease?
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HbGlu6---->lys
Still charged, no sickling |
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What is alpha-thalassemia?
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1 deletion: normal
2 deletions: trait, microcytic anemia 3 deletions: hemolytic anemia HbH=B4 4 deletions: hydrops fetalis, HbBart=gamma4 |
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What is beta-thalassemia?
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1 deletion: Beta Minor
2 deletions: "trait/intermedia/major" only HbA2 and HbF Hypoxia at 6 months |
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What is Cooley's anemia?
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Seen with Beta Thalassemia Major (No HbA ---> excessive RBC production)
Baby making RBCs everywhere Frontal bossing, hepatosplenomegaly, long extremities |
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What is virchow's triad?
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Thrombosis risk factors:
Turbulent blood flow "slow" Hypercoagulable "sticky" Vessel wall damage "escapes" |
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What does acute hypoxia cause
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SOB
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What does chronic hypoxia cause?
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Clubbing of the fingers/toes
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What is intravascular hemolysis?
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RBC destroyed in blood vessels
Low haptoglobin (binds free Hb in vasculature) |
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What is extravascular hemolysis?
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RBC destroyed in spleen
Problem with RBC membrane ---> Splenomegaly |
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What enzymes need lead?
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d-ALA dehydratase
Ferrochelatase |
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To what does EDTA bind?
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X^2 (divalent cations)
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What disease has a smooth philtrum?
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Fetal alcohol syndrome
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What disease has sausage digits?
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Williams
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What disease has 6 fingers?
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Trisomy 13 (Patau)
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What disease has 2 jointed thumbs?
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Diamond-Blackfan
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What disease has painful fingers?
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Sickle Cell
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What are the microcytic hypochromic anemias?
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"FAST Lead"
Fe def Anemia of Chronic Disease Sideroblastic anemia Thalassemia (alpha and beta) Lead Poisoning |
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Fe Deficiency Anemia
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Microcytic, Hypochromic
Increase TIBC, Menses, GI Bleed, Koilonychia |
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Anemia of Chronic Disease
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Microcytic, Hypochromic
Decreased TIBC |
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Sideroblastic anemia
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Microcytic, Hypochromic
Decreased D-ala synthase, Blood transfusions |
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Thalassemia (alpha and beta)
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alpha: AA, Asians, Chr 16 deletion
Beta: Mediterranian (Chr 11 point mutation) Microcytic, hypochromic |
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Lead Poisoning
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Microcytic Hypochromic anemia
Decreased: d-ala dehydrogenase, ferrochelatase X-ray blue line eating old paint chips |
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What are the intravascular hemolytic anemias?
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IgM
G6PD Deficiency: Sulfa drugs, moth balls, fava beans, Sudden drop in Hb Cold autoimmune: Mononucleosis, mycoplasma infections, RBC agglutination |
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What are the extravascular hemolytic anemias?
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IgG
Spherocytosis: Defective spherin or ankyrin, + osmotic fragility test Warm autoimmune: Anti-Rh Antibody, Dapsone, PTU, antimalarials, sulfa drugs Paroxysmal cold autoimmune: Bleeds after cold exposure, Donath-Landsteiner Ab Sickle Cell: "Crew cut" x-ray, AVN of Femur, short fingers |
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What are the production anemias?
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Diamond-Blackfan: No RBCs, 2-jointed thumbs
Aplastic Anemia: Pancytopenia, Autoimmune, Benzene, AZT, CAM, Radiation |
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What is basophilic stippling?
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Lots of immature cells, increased mRNA (Pb poisoning)
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What is a Bite cell (basket cell)
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Unstable Hb Inclusions (G6PD deficiency)
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What is a Burr cell (echinocyte)
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Pyruvate kinase deficiency, Liver disease, post-splenectomy
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What is Cabot's ring body?
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Vit B12 Deficiency
Pb Poisoning |
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What is a Boehle body?
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PMN leukocytosis (infection, steroids, tumor)
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What is a drepanocyte?
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Sickle cell anemia
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What is a helmet cell?
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Fragmented RBC (hemolysis) i.e. DIC, HUS, TTP
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What is a Heinz body?
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Hb precipitates and sticks to cell membranes (G6PD deficiency)
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What is a Howell-Jolly Body?
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Spleen or bone marrow should have removed nuclear fragmentsd (hemolytic anemia, spleen trauma, cancer)
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What is a Pappenheimer body?
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Fe inside cell (sideroblastic anemia)
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What is a pencil cell (cigar cell)?
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Fe Deficiency anemia
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What is Rouleaux formation?
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Multiple myeloma
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What is a schistocyte?
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Broken RBC (DIC, artifical heart valve)
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What is a sideroblast?
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Macrophages pregnant with Fe. (Genetic or multiple transfusions)
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What is a Spherocyte?
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Old RBC
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What is a spur cell (acanthocyte)?
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Lipid bilayer disease
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What is a somatocyte?
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Liver disease
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What is a target cell (codocyte)?
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Less Hb (thalassemias or Fe deficiency)
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What is a Tear Drop Cell (dacrocyte)?
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RBCs squeezed out of basement membrane (Hemolytic anemia, bone marrow cancer)
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What do platelet problems cause?
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Bleeding from the skin and mucosa
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What do clotting factor problems cause?
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Bleeding into cavities
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What causes increased PTT and bleeding time?
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Von Willebrand disease
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What is Bernard-Soulier?
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Baby w/ bleeding from skin and mucosa. Big platelets. Decreased GP1b
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What is Glanzmann's?
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Baby with bleeding from skin andm ucosa. Decreased GP2b3a
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How does factor 13 deficiency present?
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Umbilical stump bleeding (this is the first time the baby has to stabilize a clot)
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What is factor V leiden?
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Protein C can't break down factor V ---> more clots
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How does Von Willebrandt disease present in females?
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Heavy menstrual bleeding
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What are the types of Von Willebrand's dissease?
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Type 1: AD. Decreased VWF production
Type 2: AD. Decreased VWF activity +ristocetin aggregation test Type 3: AR. No VWF |
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What is hemophilia A?
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Defective factor 8. (<40% activity). Bleed into cavities i.e. head, abdoment etc
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What is Hemophilia B?
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Factor 9 deficiency. Bleed into joints (knee, etc)
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What diseases have low LAP?
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CML, PNH
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What disease has high LAP?
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Leukemoid reaction
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What is the difference between acute and chronic leukemias?
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Acute: Started in BM, squeezes RBCs out of marrow.
Chronic: Started in periphery, not constrained, will expand. |
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What is the difference between Myeloid and Lymphoid leukemias?
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Myeloid: Increased RBC, WBC, platelets, MP. Decreased Myeloid cells. Biopsy Bone Marrow.
Lymphoid: Increased: NK, T, B cells. Decreased Myeloid cells. Biopsy lymph node. |
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What defines ALL?
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<15yo male, bone pain, PAS stain +, TdT +
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What defines AML?
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15-30 yo Males. Sudan stain. Auer rods
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What defines CML?
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30-50 yo Female. t(9,22) philidelphia chromosome. bcr-abl. Decreased LAP
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What defines CLL?
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>50 yo Male w/ lymphadenopathy "soccer ball nuclei" smudge cells
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What defines Hodgkins Lymphoma?
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EBC, may have Reed-Sternberg cells.
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What are the B-Cell non-Hodgkins lymphomas?
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Follicular: T(14,18), bcl-2
Burkitt's: T(18,14), c-MYC, Starry sky MP. American Kids: Abdominal mass. African kids: Jaw mass. |
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What is polycythemia vera?
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Hct >60%, Decreased EPO, Budd-Chiari, Plethora Pruritis after bathing
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What is essential thrombocythemia?
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Very high platelets, stainable Fe
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What is myelofibrosis?
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Megakaryocytes
Fibrotic marrow (teardrop cell) Extramedullary hematopoiesis |
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What are plasma neoplasms?
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Produce lots of Ab
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What is Waldenstrom Macroglobulinemia?
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IgM, Hyperviscous
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What is monoclonal gammaopathy of undetermined significance?
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Old person w/ gamma spike
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What is multiple myeloma?
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Serum M Protein (IgG)
Urine Bence-Jones Protein Rouleaux Punched out lesions |
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What is heavy chain disease?
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Increased IgA
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What is histocytosis X?
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Kid w/ eczema, skull lesions, DI, exopthalmous
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What does the coombs test tell you?
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Ab involved
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What does the indirect coombs test tell you?
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In serum
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What is forward typing?
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Uses Ab to detect Ag. "Fabulous"
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What is backward typing?
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Uses Ag to detect Ab.
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What is hemolytic disease of the newborn?
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Rh- mom's placenta tears, 100cc baby's blood transfers to mom, mom's immune system recognizes as foreign and produces antibodies that attack the fetus
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What is RHOGAM?
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Anti-D IgG
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When do you give RHOGAM?
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1st dose: 28wks gestation of 2nd child
2nd dose: 72 hrs post partum (Rh+ baby) |
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What is the most common transplant?
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blood transfusion
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What is a syngenic transplant?
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twin to twin
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What is an autograft?
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self to self transplantation
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What is an allograft?
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Human to human transplant
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What is a xenograft?
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Cross species transplant
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What is hyperacute rejection?
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Within 12 hours (preformed ab)
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What is acute rejection?
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4 days to years later (T cells and macrophages)
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What is chronic rejection?
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>7 days, fibroblasts
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What is graft vs host disease?
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Graft is the bully so the name goes first
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What are immunoprivelaged sites?
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No lumphatic flow = no ag=easy to transplant
Cornea, brain, thymus, testes |
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What is INR?
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Measured PT/Control PT
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Risk factors for primary liver cancer
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Hep B and C
Aflatoxin Vinyl Chloride Alcohol Carbon Tetrachloride Anyline dies smoking Hemochromatosis Benzene Schistosomiasis |
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Viruses related to cancer
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HPV--> Cervical Cancer
EBV---> Lymphoma HVB/HVC ---> Liver Carcinoma HIV---> Kaposi Sarcoma |
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Carcinoid traid
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Flushing
Wheezing Diarrhea |
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HOw to dx carcinoid?
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5-HIAA in Urine
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Most common primary location of carcinoid?
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Appendix
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Most common metatstatic origin of carcinoid?
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Pancreas, Ileum
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Most common metatstatic site of carcinoid?
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Lung/Heart
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Esophageal/Gastric CA risk factors
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Smoking
Alcohol Nitrates Japanese |
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Bladder Cancer risk factors
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Smoking
Aniline dyes Benzene Aflatoxin Cyclophosphamide Schistosoma Haematobium Von Hippel-Lindau Tubular Sclerosis |
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Urticaria (hives) cancer association?
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Any but especially lymphoma
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Paget's disease cancer association
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Intraducta carcinoma
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Seborrheic keratosis cancer association
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Colon cancer (HIV is sudden increase)
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Actinic Keratosis cancer association
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Squamous cell carcinoma of the skin
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Dermatomyositis (heliotropic, malar) cancer association
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Colon Cancer
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Acanthosis Nigricans cancer association
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VIsceral cancer and end organ damage
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Erythema nodosum cancer association?
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Granulomatous (non-bacterial)
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Cancer grading
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Severity of microscopic changes
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Cancer staging
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Degree of dissemination of tumor
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l-myc
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small cell carcinoma of the lung
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c-myc
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Burkitt's Lymphoma
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n-myc
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Neuroblastoma
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c-abl
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CML, ALL
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c-myb
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Colon cancer, AML
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c-sis
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Osteosarcoma, glioma, fibrosarcoma
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ret
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MEN II and III
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k-ras
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Lung, Colon cancer
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bcl-2
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Follicular lymphoma (can show up in Burkitt's--pick follicular lymphoma first)
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Rb
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Retinoblastoma
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CEA
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Colon, Pancreas
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S-100
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Melanoma
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Breast cancer markers
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HER-II, Neu, Erb, BRCA I and II, P53, CSF-1
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AFP
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Hepatocellular carcinoma
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t(9,22)
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Philadelphia Chromosome (CML)
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t(8,14)
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Burkitt's Lymphoma
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t(14,18)
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Follicular Lymphoma
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t(15,17)
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Promyeloblastic leukemia
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t(11,14)
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Mantle Cell Lymphoma
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t(11,22)
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Ewings Sarcoma
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t(17,22)
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Neurofibromatosis
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