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214 Cards in this Set
- Front
- Back
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initial precursor for platelets
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megakaryocyte
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immature RBC
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reticulocyte
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plasma cells are derived from what
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B cells
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most abundant WBC
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netrophils
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least abundant WBC
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basophils
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RBCs source of energy
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glucose (90% from lactate)
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lifespan of an RBC
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120 days
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what is anisocytosis
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varying sizes of RBCs
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what is poikilocytosis
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varying shapes of RBCs
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what do the dense granules of a platelet secrete
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ADP and calcium
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what do the alpha granules of a platelet secrete
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vWF and fibrinogen
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life span of a platelet
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8-10 days
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whats the main vWF receptor
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Gp1b
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whats the main fibrinogen receptor
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GpIIb/IIIa
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main WBC in acute inflammation and bacterial infection
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neutrophils
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which WBC are barr bodies found in
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neutrophils
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which WBC are hypersegmented in B12 or folate deficiency
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neutrophils
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which WBC differentiates into macrophages
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monocytes
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what cytokine activates macrophages
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IFN-y
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main WBC that mediates parasitic infection
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eosinophils
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which cells secrete histamine
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mast cells and basophils
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which cells secrete heparin
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basophils
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which WBC undergo stippling in lead poisoning
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basophils
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MAIN antigen presenting cell
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dendritic cells
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these cells have a clock-face chromatin distribution
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plasma cells
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which cells produce antibodies
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B cells
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neoplasm of the plasma cells
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multiple myeloma
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Rh- mother and Rh+ father can have a child with what condition
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erythroblastosis fetalis
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how to prevent erythroblastosis in susceptible children
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administer Rhogam to mother before birth during 1st pregnancy
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which child does erythroblastosis normally FIRST affect
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2nd child
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universal donor blood type
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type O
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universal recipient blood type
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type AB
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someone with type A blood has which antigen on the RBCs and which antibody in the plasma
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type A blood: A antigen on RBCs and B antibodies in plasma
type B blood: B antigen on RBCs and A antibodies in plasma type AB blood: A and B antigens on RBCs and no antibodies in plasma type O blood: no antigens on RBCs and A&B antibodies in plasma |
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deficiency of factor VIII
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hemophilia A
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deficiency of factor IX
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hemophilia B
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which clotting factors are Vit K dependent
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Factors II, VII, IX, X, proteins C&S
"diSCo was invented in 1972" |
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antithrombin inhibits which factors
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factors IX, X, XI, XII, and thrombin
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drug that binds and activates antithrombin III
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heparin
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which clotting pathway is triggered by tissue damage
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extrinsic
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which clotting pathway is triggered by the Hageman Factor (factor XII)
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intrinsic
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what is the tissue factor that activates the extrinsic pathway
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thromboplastin
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clotting factor that unites the extrinsic and intrinsic pathways
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factor X
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thrombin activates which clotting factors
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thrombin activates V, VIII, XI
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calcium is required for which clotting factors
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calcium is required for factors I, II, X, XIII
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what binds to and inactivates thrombin
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thrombomodulin
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what activates protein C
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thrombomodulin
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are proteins C & S pro-coagulants or anti-coagulants
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C & S are anti-coagulants
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rate-limiting step of clotting
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forming prothrombin
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converts fibrinogen into fibrin
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thrombin
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prothrombin is formed in what organ and whats its function
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formed in the liver and it activates thrombin
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which clotting factor cross-links fibrin
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factor XIII
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function of plasmin
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breaks down clots to form fibrin degeneration products; also activates C3
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what activates plasminogen
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tPA
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condition in which factor V is resistant to protein C thus there is increased clotting
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Factor V Leiden mutation
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enzyme inhibited by warfarin
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Vit K dependent epoxide reductase
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platelets adhere to a site of injury and bind via what?
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vWF (GpIb receptors)
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after platelet adherence, they release calcium and ADP; ADP then induces expression of which receptors which ultimately binds fibrinogen
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GpIIb/IIIa
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thromboxane's effect on clotting
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promotes clotting (increases platelet aggregation)
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prostaglandin's effect on clotting
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inhibits clotting (decreases platelet aggregation)
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which drug inhibits GpIIb/IIIa
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Abciximab
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pathologic RBC found in abetalipoproteinemia
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Acanthocyte (spur cells)
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basophilic stippling is seen in what 4 conditions
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Thalassemias
Anemia of chronic disease Iron deficiency Lead poisoning ("TAIL") |
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pathologic RBCs seen in G6PD deficiency
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bite cells and Heinz bodies
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treatment of sideroblastic anemia
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B6
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treatment of megaloblastic anemia
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B12 and folic acid
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conditions associated with schistocytes (aka helmet cells)
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DIC, TTP, HUS
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pathologic RBC associated with myelofibrosis
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dacrocytes ("tear-drop cells")
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how are heinz bodies formed
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oxidation of iron from ferrous to ferric form causes denaturation of hemoglobin
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Howell-Jolly bodies suggest what
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spleen dysfunction
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examples of microcytic, hypochromic anemias
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iron deficiency
alpha-thalassemia beta-thalassemia lead poisoning sideroblastic anemia |
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characterized by the clinical triad of iron deficiency anemia, esophageal webs, and atrophic glossitis
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Plummer Vinson syndrome
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characterized by gene mutations in alpha-globin
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alpha-thalassemia
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deletion of how many genes in alpha-thalassemia forms Hb Barts (y4) causing hydrops fetalis
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deletion of 4 genes
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deletion of how many genes in alpha-thalassemia forms Hb B4 (HbH disease)
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deletion of 3 genes
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this hematologic condition is characterized by point mutations in the splicing sites and promoter sequences of hemoglobin
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beta-thalassemia
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difference in pathogenesis of B-thalassemia minor and B-thalassemia major
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B-thalassemia minor (heterozygote): B chain is UNDERPRODUCED; increased HbA2
B-thalassemia major (homozygote): B chain is ABSENT; expansion of marrow causes skeletal deformities (chipmunk facies and crew cut appearance on xray) |
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common finding in both minor and major B-thalassemia
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increased fetal hemoglobin
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lead inhibits what 2 enzymes
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ferrochelatase and ALA dehydratase
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cause of sideroblastic anemia
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X-linked defect in ALA synthase thus blocking heme synthesis
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blue/black lines (Burtons lines) on the gingiva suggest what
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lead poisoning
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treatment for lead poisoning
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dimercaprol and EDTA
(succimer in kids) |
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hematologic disorder linked to defects in ankyrin, band 4.1, and spectrin
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hereditary spherocytosis
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xray appearance of the skull in Sickle Cell patients
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crew-cut appearance
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what amino acids are substituted for each other in Sickle cell
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glutamic acid is replaced with valine
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which chain is mutated in sickle cell
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B-chain
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patient with sickle cell trait (i.e. heterozygotes) are resistant to what disease
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malaria
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cause of osteomyelitis in sickle cell patients
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salmonella
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kidney condition linked to sickle cell
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papillary necrosis
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DOC for sickle cell patients
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hydroxyurea
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lab findings reveal increased hemosiderin in the urine; complement if found to be inhibited in the RBCs
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paroxysmal nocturnal hemoglobinuria
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warm agglutinins are linked to what immunoglobulins
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IgG
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cold agglutinins are linked to what immunoglobulins
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IgM
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2 conditions that test positive for warm agglutinins
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SLE and CLL
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infections associated with cold agglutinins
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mycoplasma pneumonia and mononucleosis
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test to assess for autoimmune hemolytic anemias
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Coombs test
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what substance accumulates in the blood in lead poisoning
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protoporphyrin
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accumulations of porphobilinogen, ALA, and uroporphyrin are suggestive of what disease
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acute intermittent porphyria
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accumulation of uroporphyrin is suggestive of what disease
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porphyria cutanea tarda
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deficiency in porphobilinogen deaminase
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acute intermittent porphyria
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deficiency in uroporphyrinogen decarboxylase
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porphyria cutanea tarda
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Major presenting symptom is blistering cutaneous photosensitivity
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porphyria cutanea tarda
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initial 2 precursors for heme synthesis
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glycine and succinyl-CoA
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PT assesses which clotting pathway
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extrinsic
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PTT assesses which clotting pathway
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intrinsic
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heparin affects which clotting pathway
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intrinsic
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warfarin affects which clotting pathway
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extrinsic
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defect in Bernard-Soulier disease
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defective Gp1b thus defect in platelet to collagen adhesion
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defect in Glanzmann's thrombasthenia
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defective GpIIb/IIIa thus defect in platelet to platelet aggregation
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lab value difference between Bernard-Soulier and Glanzmann's
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Bernard-Soulier has thrombocytopenia
Glanzmanns has normal platelet count |
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anti-GpIIb/IIIa antibodies are suggestive of what disease
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ITP
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characterized by a deficiency in ADAMTS13 (vWF metalloprotease)
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TTP
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MOST common bleeding disorder
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von Willebrand disease
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DOC for von Willebrand disease
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desmopressin (releases vWF stored in the endothelium)
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lab values in DIC
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decreased platelets, increased bleeding time, increased PT, increased PTT, decreased fibrinogen, increased fibrin degradation products (d-dimer), schistocytes, decreased factors V and VIII
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2 MOST common bacterial causes of DIC
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E.coli and N. meningitidis
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is the anemia in DIC macrocytic, microcytic, or normocytic?
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normocytic
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morphologic cells in Hodgkins lymphoma
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Reed-Sternberg cells
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CD markers of Reed-Sternberg cells
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CD15 and CD30
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virus associated with Hodgkin lymphoma
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EBV
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virus most commonly associated with Non-Hodgkins lymphoma
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HIV
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these are bi-lobed cells that appear as "owl's eyes" and are pathologic for a certain cancer
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Reed-Sternberg cells
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MOST common type of Hodgkins lymphoma
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nodular sclerosis (type 1)
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which Hodgkins lymphoma type has a lacunar variant
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nodular sclerosis (type 1)
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which Hodgkins lymphoma type has the WORST prognosis
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lymphocyte depletion (type IV)
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which Hodgkins lymphoma type is characterized by "popcorn cells"
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lymphocyte predominance (type V)
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MOST common translocation in Burkitts lymphoma
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8;14
(additional translocations include 8;22 and 2;8) |
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gene mutation linked to Burkitts lymphoma
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c-myc
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morphologic appearance of the cells in Burkitts lymphoma
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starry-sky appearance
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2 viruses linked to Burkitts lymphoma
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EBV and HIV
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MOST common presentation of Burkitts in Africa
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lesion in the jaw (mandible)
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MOST common presentation of Burkitts in the US
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mass in the pelvis or abdomen
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diffuse large B-cell lymphoma usually arises from what special tissue
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Waldeyers ring
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gene mutation in diffuse large B-cell lymphoma
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bcl-6
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translocation in mantle cell lymphoma
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11;14
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translocation in follicular lymphoma
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14;18
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gene mutation in follicular lymphoma
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bcl-2
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which lymphoma follows an indolent waxing/waning course
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follicular lymphoma
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virus linked to adult T cell lymphoma
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HTLV-1
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patient presents with back pain and weight loss; xray reveals punched-out bone lesions; UA reveals pathologic proteins suggestive of primary amyloidosis; an RBC smear shows stacking
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multiple myeloma
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what is rouleaux formations
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stacking of RBCs seen in multiple myeloma
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proteins found in the urine in multiple myeloma
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bence jones proteins (AL type)
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morphologic cells in multiple myeloma
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flame cells, mott cells, russell bodies, and dutcher bodies
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genetic mutation linked to multiple myeloma
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RANKL
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MOST common overall cancer in children
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ALL
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ALL is linked to what chromosomal abnormality
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trisomy 21 (Down's)
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tumor marker for ALL
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terminal deoxynucleotidyl transferase (TdT)
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translocation linked to ALL
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12;21
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MOST common leukemia in adults
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CLL
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morphologic cells in CLL
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smudge cells
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test to check for hairy cell leukemia
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TRAP test (yields a "dry tap")
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2 translocations linked to AML
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8;21 and 15;17
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treatment of AML
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target the retinoic acid receptors (RAR-a)
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morphologic feature of AML
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auer rods
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translocation in CML
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9;22
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combination gene mutation in CML
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bcr-abl
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MOST common presenting symptom of CML
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splenomegaly (dragging sensation)
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the Philadelphia chromosome is linked to what cancer
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CML (9;22)
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DOC to treat CML
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bcr-abl inhibitors (imatinib)
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increased myeloblasts suggest which leukemia
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AML
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increased myeloid stem cells ("blast crisis") suggest which leukemia
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CML
|
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translocation linked to Ewing sarcoma
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11;22
|
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morphologic feature of Langerhans cells histiocytosis
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Birbeck granules
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mutation linked to chronic myeloproliferative disorders
|
JAK2 mutation
|
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erythropoietin levels in PCV
|
decreased
(increased in all other polycythemias) |
|
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antidote for heparin overdose
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protamine
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major SE of heparin
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HIT (hypercoagulable state)
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DOC for patient who experiences HIT while taking heparin
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Lepirudin or Bivalirudin
|
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blood thinner given as prophylaxis during heart surgery
|
warfarin
|
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blood thinner that is absolutely contraindicated in pregnancy (category X)
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warfarin
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treatment for warfarin overdose
|
vit K, FFP
|
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major SE of warfarin
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skin/tissue necrosis
(occurs 3-10 days after starting treatment secondary to blocking protein C) |
|
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clinical uses of thrombolytics (tPA, streptokinase)
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MI, stroke, PE
|
|
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MOA of aspirin
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irreversibly blocks cyclooxygenase which directly prevents the formation of thromboxane A2 and prostaglandins from arachidonic acid
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drug linked to Reye's syndrome
|
aspirin
|
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major SE of aspirin
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GI bleeding, nephrotoxicity, tinnitus
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MOA of clopidogrel and ticlopidine
|
blocks ADP receptors which inhibits platelet aggregation (indirectly inhibits GpIIb/IIIa)
|
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SE of ticlopidine
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neutropenia
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SE of methotrexate
|
myelosuppression, fatty change in liver, mucositis, teratogenic
|
|
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DOC to reverse SE of methotrexate
|
leucovorin
|
|
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non-cancer conditions that methotrexate is used for
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rheumatoid arthritis
psoriaisis abortions ectopic pregnancy |
|
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MOA of methotrexate
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inhibits dihydrofolate reductase decreasing DNA/protein synthesis
|
|
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MOA of 5-FU
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inhibits thymidylate synthase thus decreasing DNA/protein synthesis
|
|
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treatment for overdose of 5-FU
|
thymidine
|
|
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MOA of 6-MP
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decreases de novo purine synthesis (activated by HGPRTase)
|
|
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toxicity of 6-MP increases when combined with what drug
|
allopurinol
|
|
|
MOA of cytarabine
|
inhibits DNA polymerase
|
|
|
DOC for common childhood tumors including Wilms tumor, Ewing sarcoma, and rhabdomyosarcoma
|
dactinomycin (actinomycin D)
|
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SE of doxorubicin
|
cardiotoxicity, myelosuppression, alopecia
|
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MOA of bleomycin
|
induces free radicals to form breaks in the DNA
|
|
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SE of bleomycin
|
pulmonary fibrosis
|
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MOA of etoposide
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inhibits topoisomerase II
|
|
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SE of cyclophosphamide
|
hemorrhagic cystitis, myelosuppression
|
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DOC to prevent SE of cyclophosphamide
|
MESNA
|
|
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DOC for brain tumors
|
Nitrosoureas (carmustine, lomustine)
|
|
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MOA of vincristine/vinblastine
|
bind tubulin in M phase and block polymerization of microtubules so that mitotic spindle don't form
|
|
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MOA of paclitaxel
|
hyperstabilizes microtubules in M phase so that mitotic spindles can't break down
|
|
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SE of vincristine
|
neurotoxicity, paralytic ileus
|
|
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SE of vinblastine
|
myelosuppression
|
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MOA of cisplastin/carboplastin
|
cross-links DNA
|
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MOA of hydroxyurea
|
inhibits ribonucleotide reductase during S phase
|
|
|
DOC for estrogen-positive breast cancer
|
tamoxifen
|
|
|
SE of tamoxifen
|
increases risk for endometrial cancer
|
|
|
alternative drug to tamoxifen with same MOA but does NOT increase risk for endometrial cancer
|
raloxifene
|
|
|
DOC for breast cancer that expresses HER-2 (erb-B2)
|
Trastuzumab
|
|
|
DOC for GI stromal tumors
|
Imatinib
|
|
|
cell cycle specific cancer drugs
|
bleomycin
vincristine 5-FU 6-MP methotrexate etoposide |
|
|
cell cycle nonspecific cancer drugs
|
alkylating drugs
doxorubicin cisplastin nitrosoureas |
|
|
MOA of cyclophosphamide
|
alkylate DNA
|
|
|
MOA of nitrosoureas (carmustine, lomustine)
|
alkylate DNA
|
|
|
common chemo combination used against testicular cancer
|
bleomycin
vinblastine etoposide cisplastin |
|
|
common chemo combination used against Non-Hodgkins lymphoma/leukemia
|
cyclophosphamide
doxorubicin vincristine rituximab prednisone |
|
|
common chemo combination used in estrogen-positive breast cancer
|
cyclophosphamide
methotrexate 5-FU tamoxifen ("5CMT" --> 5-country music television) |
|
|
DOC for prostate cancer
|
flutamide
|
|
|
MOA of flutamide
|
antagonist of testosterone (androgen) receptors
|
