Usmle 1 Path Blood Dz

Front 1

RBC form:

Spherocyte
(2)

Back 1

Hereditary Spherocytosis;

Autoimmune hemolysis

Front 2

RBC form:

Elliptoctye

Back 2

Hereditary Elliptocytosis

Front 3

RBC form:

Macro-ovalocyte
(2)

Back 3

Megaloblastic anemia;

Marrow failure

Front 4

RBC form:

Helmet cell (schistocyte)
(2)

Back 4

DIC;

Traumatic hemolysis

Front 5

RBC form:

Teardrop cell

Back 5

Myeloid metaplasia w/ myelofibrosis

Front 6

RBC form:

Acanthocyte

Back 6

Spiny appearance in Abetalipoproteinemia

Front 7

RBC form:

Target cell
(4)*

Back 7

HALT:

HbC disease;

Asplenia;

Liver Dz;

Thalassemia

Hint 7

HALT

Front 8

RBC form:

Poikilocyte
(2)

Back 8

TTP/HUS;


DIC

Front 9

RBC form:

Burr cell

Back 9

TTP/HUS

Front 10

(3)* Microcytic Anemias

Back 10

Iron deficiency;

Thalassemias;

Lead poisoning

Hint 10

LIT

Front 11

Dx:

pallor, fatigue, DOE, decreased Hct, Hb, RBC, hypochromic, microcytic, Increased TIBC

Back 11

Iron Deficiency anemia

Front 12

Differential for Iron deficient anemia and reason of difference
(2)

Back 12

Anemia of chronic Dz - TIBC is Low

B-Thalassemia minor - A2 Hb is increased

Front 13

(5)* causes of Eosinophilia

Back 13

NAACP:

Neoplasm;
Asthma;
Allergy;
Collagen Vascular Dz;
Parasites

Hint 13

NAACP

Front 14

what does Protein C and S do to coagulation cascade?

what are they dependent on?

Back 14

Inactivate Va and VIIIa


dependent on: Vitamin K

Front 15

what does Antithrombin III inactivate in the coagulation cascade?
(4)

what drug is Antithrombin III activated by?

Back 15

Inactivates:
IXa,
Xa,
XIa,
Thrombin

Drug: Heparin

Front 16

what drug generates Plasmin to cleave fibrin?

Back 16

tPA

Front 17

(4)* causes of folate deficiency

Back 17

IPOD:

Intestinal malabsorption
Pregnancy;
Oral contraceptives or Phenytoin;
Diet (usu alcoholism)

Hint 17

IPOD

Front 18

Dx:

normochromic, normocytic anemia, inflammatory state, decreased Iron, decreased TIBC, Increased Ferritin

Back 18

Anemia of Chronic Dz

Front 19

Dx:

pancytopenia, fatigue, pallor, mucosal bleeding, petechiae, hypocellular bone marrow

Back 19

Aplastic anemia

Front 20

what (2) changes in bloodwork indicate RBC hemolysis?

how is immune vs non-immune cause distinguished?

Back 20

blood:
Decreased Haptoglobin;
Increased LDH

Immune: Direct Coombs test

Front 21

what medication causes Aplastic anemia?

Back 21

Chloramphenicol

Front 22

Definition:

anemia due to shortening of RBC life span
(increased RBC destruction)

what is common lab to all types?

Back 22

Hemolytic anemia

common lab:
Increased Indirect Bilirubin

Front 23

(4)* Hemolytic anemia types

Back 23

Heme MAP:

Hereditary Spherocytosis;

Microangiopathic (DIC, TTP/HUS)

Autoimmune anemia;

Paroxysmal Noctournal Hemoglobinuria (PNH)

Hint 23

Heme MAP

Front 24

Dx:

extravascular hemolysis, spherocytosis, positive Direct Coombs

What gammaglobulin?

Back 24

Warm Hemolytic anemia

Gamma: IgG

[Warm weather is GGGreat]

Front 25

Dx:

extravascular hemolysis, spherocytosis, recent pneumonia or mono

what gammaglobulin?
what antibody is it mediated by?

Back 25

Cold Hemolytic anemia

Gamma: IgM

Ab: Anti-I Ab (has I blood antigen)

[Cold ice cream...MMMM]

Front 26

what autoimmune anemia deals with newborns?

Back 26

Erythroblastosis Fetalis

(Rh or ABO incompatability)

Front 27

Dx:

Increased Mean Corpuscular Hemoglobin Concentration
(MCHC)

Back 27

Hereditary Spherocytosis

Front 28

Dx:

normocytic, normochromic, RBC are small and round w/ no central pallor, increased MCHC

where is defect?
(2)
Genetics?

Back 28

Hereditary Spherocytosis

defect:
Spectrin or Ankyrin

genetics:
Auto Dominant

Front 29

Definition:

intravascular hemolysis due to a membrane defect causing increased sensitivity of RBC to the lytic activity of complement; causes blood red urine in morning

what gene mutation?
what is high in urine?
what is test to Dx?

Back 29

Paroxysmal Noctournal Hemoglobinuria

Gene: PIG-A (impaired GPI)

urine: Increased Hemosiderin

Test: Ham test (C59-neg RBC)

Front 30

RBC forms:

"Bite cells"

Back 30

G6PD deficiency

Front 31

(2) common enzyme deficiencies causing Anemia

Back 31

G6PD deficiency;

Pyruvate Kinase deficiency

Front 32

Dx:

Autosplenectomy

Back 32

Sickle cell

Front 33

what bug affects the bone in Sickle cell?

Back 33

Salmonella

Front 34

Dx:

microcytosis, hypochromia, target cells, inc Hb-F, hemosiderosis

Back 34

Beta Thalassemia Major

Front 35

Dx:

minimal hypochromic, microcytic anemia, inc Hb-A2

Back 35

Beta Thalassemia Minor

Front 36

what is the serum of a 3/4 loss in alpha thalassemia?

4/4 loss? (name)

Back 36

3/4: HbH (B4-tetramers)


4/4: Hb-Barts
(Hydrops fetalis - fetal death)

Front 37

D-negative mother gives birth to a D-positive child. what should be administered and to whom?

Back 37

Anti-D IgG to mother

Front 38

when does Hemolytic Dz of the newborn occur w/ respect to mother and baby's blood?

Back 38

Rh incompatability:
Mother - d (Rh-)
Child - D (Rh+)

ABO incompatability:
Mother - O
Child - A, B, or AB

Front 39

which blood condition has ineffective erythropoiesis?

Back 39

B-Thalassemia Major

Front 40

what cell provides a membrane phospholipase to promote Arachidonic Acid metabolism?

Back 40

Platelets

Front 41

what promotes platelet aggregation?
(6)*

Back 41

PET TAC:

PAF,
Epinepherine,
Thrombin,
Thromboxane,
ADP,
Collagen

Hint 41

PET TAC

Front 42

Lab abnormalities for:

all Throbocytopenias

Back 42

Dec Platelet count,

Inc Bleeding Time

Front 43

Lab abnormalities for:

Hemophilia A or B

Back 43

Inc PTT (only)

Front 44

Lab abnormalities for:

von Willebrand's Dz

Back 44

Inc Bleeding Time

Inc PTT

Front 45

Lab abnormalities for:

DIC

Back 45

Dec Platelet count,

Inc Bleeding Time,

Inc PT,

Inc PTT

Front 46

Definition:

Hereditary resistance to activated Protein C;
MCC of hereditary thrombophilia

Back 46

Factor V Leiden

Front 47

Factors associated w/ PT

Back 47

Factors:

II, V, VII, X

Front 48

Factors associated w/ PTT

Back 48

All except VII

Front 49

what (2) shunts can cause a paradoxical emboli?

Back 49

Patent foramen ovale,

ASD

Front 50

Factor deficiency:

Hemophilia A

Back 50

factor VIII

Front 51

Factor deficiency:

Hemophilia B

Back 51

factor IX

Front 52

what (2) Dx will cause Inc PT?

Back 52

DIC,

Macrohemorrhages

Front 53

Definition:

Autosomal dominant Dz w/ local malformations of venules and capillaries of skin and mucous membranes, often complicated by hemorrhage

Back 53

Osler-Weber-Rendu syndrome

Front 54

Dx:

thromboycytopenia, increased megakaryocytes, anti-platelet Ab

Back 54

ITP

Front 55

Dx:

thrombocytopenia, helmet cells (schistocytes), Inc LDH, neuro abnormalities, renal insufficiency, fever

Back 55

TTP

Front 56

Definition:

Defect in platelet adhesion leading to decreased VIII

Back 56

von Willebrand Dz

Front 57

Definition:

Autosomal recessive problem w/ unusually large platelets w/ lack of a glycoprotein needed for adhesion

what glycoprotein?

Back 57

Bernard-Soulier Dz

glycoprotein:
GPIb-IX

[Bad-Sticking Dz]

Front 58

difference b/t platelet Adhesion and Aggregation

which does aspirin affect?

Back 58

Adhesion - sticking to walls

Aggregation - sticking to each other
(Aspirin)

Front 59

Definition:

Dz caused by the hereditary deficiency of a platelet surface glycoprotein required for formation of fibrinogen bridges b/t adjacent platlets (can't aggregate)

what glycoprotein?

Back 59

Glanzmann Thrombasthenia

glycoprotein:
GPIIb-IIIa

[Glanzmann cant aGGregate]

Front 60

Definition:

widespread systemic clotting w/ consumption of platelets and coagulation factors (II, V, VIII and fibrinogen)

who is it most commonly seen in?

Back 60

Disseminated Intravascular Coagulation
(DIC)

MC: OB patient

Front 61

Dx:

low platelet count, increased bleeding time & PT/PTT, schistocytes, Increased fibrin split products

what test to confirm?

Back 61

DIC

test:
D-Dimer test (fibrin split products)

Front 62

(4)* causes of DIC

Back 62

COTS:

Cancer;
OB malfunction;
Transfusion rxn;
Sepsis (gram negative bug)

Hint 62

DIC-COTS

Front 63

what is the only platelet disorder that does not have an Increased Bleeding Time?

Back 63

Hemophilia (A or B)

Front 64

what is the AA substitution of Sickle cell?
(what position/chain?)

Back 64

VAL -> GLU at position 6
on Beta-chain

Front 65

what is the AA substitution of HgC?

Back 65

LYS -> Glutamic acid

Front 66

RBC forms:

Howell-Jowel Bodies
(2)

Back 66

Spleen problem

Sickel cell

Front 67

MCC Cancer pushing out Tear drop cells in:

1. Children

2. Man

3. Woman

Back 67

Children = ALL

Man = Prostate Mets

Woman = Breast Mets

Front 68

MCC of malignancy in children

Back 68

ALL

Front 69

list Leukemia type by age of onset

Back 69

ALL: < 15 yo

AML: 15 - 40

AML + CML: 40 - 60
(AML has auer rod)

CLL: > 60 yo

Front 70

Dx:

Inc lymphoblasts, positive CD10 or CALLA, responsive to therapy

Back 70

ALL

Front 71

Dx:

Inc Myeloblasts, Auer rods

what translocation?

what does it lead to?

Back 71

AML-M3


t(15;17) Retinoic acid

leads to: DIC

Front 72

MC AML type

what translocation?

Back 72

AML-M2

t(8;21)

Front 73

Dx:

RBC w/ crystal inclusions

Back 73

HbC

Front 74

which AML affects the skin and gum and deals w/ Monocytes?

Back 74

AML-M5

Front 75

Dx:

Inc lymphoblasts, positive CD5, hypogammaglobinemia, smudge cells, warm hemolytic anemia

Back 75

CLL

Front 76

Dx:

splenomegaly, pancytopenia, B-cell dz w/ hair-like projections

what is test?

Back 76

Hairy cell Leukemia


Test:
TRAP

Front 77

Leukemia that is CD10 positive

Back 77

ALL

Front 78

Dx:

Extreme leukocytosis, myeloid precursor cells, low LAP

Back 78

CML

philadelphia chromosome - t(9;22)
bcr-abl

Front 79

Dx:

Marked erythrocytosis, splenomegaly, decreased erythropoietin, bleeding and thrombosis

Back 79

Polycythemia vera

Front 80

Dx:

extramedullary hematopoiesis (liver and spleen), myelofibrosis in bone marrow, anemia, massive splenomegaly, teardrop-shaped RBC

Back 80

Chronic Idiopathic Myelofibrosis
(MMM)

Front 81

Dx:

thrombocytosis in periphery and megakaryocytosis in marrow (platelets > 1 million)

Back 81

Essential Thrombocythemia

Front 82

Dx:

Atypical lymphocytes, young-adult, hepatosplenomegaly, fever and sore throat

Dx test?

Back 82

Mononucleosis

(EBV)

Test: Heterophil Ab

Front 83

Dx:

lytic lesions in bone, bone pain, M-protein spike, hyperglobinemia, hypercalcemia, renal insufficiency, immunoglobulins in urine, RBC congregation

Back 83

Multiple Myeloma

MR BRA:
M-spike (IgA or IgG),
Rouleau form of RBC,
Bone lesions (lytic),
Renal insuff: Bence-Jones protein,
Amyloidosis

Front 84

Dx:

many cells in intermediate stage b/t B-cells and plasma cells, Monoclonal IgM spike, Hyperviscosity, abnormal bleeding, retinal vascular dilation, Bence-Jones protein (10%)

Back 84

Waldenstrom Macroglobulinemia

Front 85

t(9;22)

Back 85

CML

Front 86

t(8;14)

Back 86

Burkitt lymphoma

Front 87

t(15;17)

Back 87

AML type M3

Front 88

what does AML-M3 respond to?

Back 88

all-Trans Retinoic Acid
(vit A)

Front 89

t(11;22)

Back 89

Ewing sarcoma

Front 90

t(11;14)

Back 90

Mantle cell lymphoma

Front 91

(4) types of Hodgkin lymphomas

what cell is seen in all of them?

Back 91

Nodular Sclerosing,

Mixed Cellularity,

Lymphocyte Predominant,

Lymphocyte Depleted

(Reed-Sternberg cells)

Front 92

Dx:

fibrous bands in LN and Lacunar cells, CD15 and CD30 positive, more common in women, usu in mediastinum

Back 92

Nodular Sclerosing
Hodgkins lymphoma

Front 93

Dx:

Hodgkin's w/ most RS cells, eosinophil and plasma cell infiltrate

Back 93

Mixed Cellularity
Hodgkins lymphoma

Front 94

Dx:

lymphoma common in men < 35, "potato in neck", popcorn cells, best prognosis

Back 94

Lymphocyte Predominant
Hodgkins lymphoma

Front 95

Dx:

lymphoma w/ very few lymphocytes and extensive fibrosis and necrosis, poorest prognosis

Back 95

Lymphocyte Depletion
Hodgkins lymphoma

Front 96

Lymphoma staging I-IV

Back 96

I: one LN

II: >1 LN on same side of diaphragm

III: LN involvement on both sides of diaphragm and possibly spleen

IV: spread to one or more extralymphatic organs

Front 97

Dx:

B-cell lymphoma, older person, positive CD5, possible CLL

Back 97

Small Lymphocytic Lymphoma

Front 98

Dx:

B-cell lymphoma, angulated grooved cells in Nodular pattern, bcl-2 positive

Back 98

Follicular lymphoma

Front 99

Dx:

similar to Small Lymphocytic lymphoma, but w/ t(11;14)

Back 99

Mantle Cell lymphoma

Front 100

Dx:

lymphoma that arises in sites of chronic inflammation or autoimmune Dz. (Sjogren: parotid; Hashimoto's: thyroid; H.pylori gastritis: stomach)

what is another name?

Back 100

Extranodal Marginal Zone B-cell lymphoma

(MALToma)

Front 101

Dx:

B-cell lymphoma that presents as a large, extra-nodal mass; seen in elderly and AIDS patients

Back 101

Diffuse Large B-cell lymphoma

Front 102

Dx:

T-cell lymphoma seen in children, from thymic lymphocytes, can progress to ALL

Back 102

(T-precursor) Lymphoblastic lymphoma

Front 103

Dx:

B-cell lymphoma, linked to EBV infection, "starry sky" appearance

Back 103

Burkitt's lymphoma
(c-myc)

t(8;14)

Front 104

what is the difference in presentation of Burkitt's in Africa and America?

Back 104

Africa - Jaw lesion


America - Pelvis or Abdomen lesion

Front 105

Dx:

lymphoma w/ dermal infiltrates of CD4 cells w/ cerebriform nuclei and "Pautrier microabscesses" in epidermis

Back 105

Cutaneous T-cell Lymphoma

Front 106

Definition:

Leukemic form of Cutaneous T-cell Lymphoma (w/ skin lesions and cerebriform nuclei)

Back 106

Sezary syndrome

Front 107

difference b/t the M-spike in Multiple Myeloma and Waldenstrom?

Back 107

MM: IgA or IgG - M-spike

Waldenstrom: IgM - M-spike