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82 Cards in this Set

  • Front
  • Back

Most common type of megoblastic/macrocytic anemia caused by Vitamin B12 deficiency

Pernicious Anemia

The 5 steps of erythropoiesis

Describe the role of EPO in erythropoiesis

The absence of intrinsic factor from the gastric parietal cells causes which type of anemia and results in inadequate supplies of which vitamin?

pernicious anemia




vitamin B12

Too many red blood cells

polycythemia

too few red blood cells

anemia

red cells that are present in various sizes

anisocytosis

red cells that are present in various shapes

poikilocytosis

Classic anemia symptoms

Fatigue, weakness, dyspnea, tachycardia, pallor

In order for vitamin B12 to be absorbed, it must be coupled with

IF

If a parts of the stomach are removed, a pt may develop which type of anemia? why?

Pernicous anemia


remove the parental cells that make the IF

Which type of anemia develops neurologic symptoms of non- reversible nerve demyelination, parenthesis of the feet and fingers, and difficulty walking?

Pernicous Anemia

Loss of appetite, abdominal pain, beefy red tongue (atrophic glottitus), icterus, splenic enlargement sings of

pernicous anemia

Megoblastic anemias that are due to defective DNA synthesis.




Due to deficiencies in Vitamin B 12 or folate

Normochronic-macrocytic anemia

Anemias characterized by abnormally small red cells and contain reduced amounts of hb

Hypochromic-macrocytic anemias

Type of anemia that is caused by inadequate dietary intake of iron or excessive blood loss




OR




Metabolic or functional deficiency

Iron deficiency anemia

Progression of iron deficiency causes

Pallor


Koilonychia


glossitius


cognitive impairment


pica

Symptoms manifest in iron deficiency anemia at what hgb?

7-8g/dl

Pallor


Sign of Iron Deficiency Anemia

Koilonychia


Sign of Iron Deficiency Anemia

Glossitus


sign of Iron Deficiency Anemia

red cells that are relatively normal in size and hemoglobin content but insufficient in number

normochromic-normocytic anemia

anemia that is due to accelerated destruction of red blood cells




can be episodic or continuous leading to increased levels of EPO

Hemolytic Anemia

Two types of autoimmune hemolytic anemias

warm agglutinin antibody hemolytic anemia


cold agglutinin hemolytic anemia

Type of hemolytic anemia where IgE binds to the eurthrocyte at normal body temperatures causing it to bind to Fc receptors on monocytes and splenic macrophages and are removed by phagocytosis

warm autoimmune hemolytic anemia

autoimmune disease characterized by the presence of HIGH concentrations of circulating IgM directed against red blood cells

cold agglutinin hemolytic anemia

Exposure to cold initiates acute and severe intravascular hemolysis that results in hemoglobinuria

cold agglutinin hemolytic anemia

type of anemia that results from an allergic reaction against foreign antibodies of a drug.

Drug induced hemolytic anemia

Describe the Hapten model of drug hemolytic anemia.



drug + RBC + IgG = hemolysis by complement phagocytosis




**drug is usually pen/ceph***


not usually hydrocortisone

Describe the Immune complex model of induced drug hemolytic anemia.

Immune complex activate C protein --> C3b + RBC --> C3B +RBC +IgG= hemolysis

Immune complex activate C protein --> C3b + RBC --> C3B +RBC +IgG= hemolysis

Describe the autoimmune model of drug induced hemolytic anemia.

AB + RBC = hemolysis

AB + RBC = hemolysis

Mild or moderate anemia in individuals with conditions of chronic disease or inflammation




what causes the anemia?

Anemia of chronic disease


1. decreased RBC life span


2. suppressed production of EPO


3. ineffective bone marrow progenitor response to EPO


4. altered iron metabolism and iron sequestration in macrophages

chronic myeloproliferative disease that is characterized by overproduction of RBC frequently with increased levels of WBC and platelets

polycythemia vera

leukocyte count that is higher than normal

leukocytosis




(normal response to physiologic stressors or pathologic)



leukocyte count that is lower than normal

leukopeia




NEVER NORMAL




associated with a decrease in neutrophils--> likely infection

Leukocytes that are granulocytes

Neutrophils


eosinophils


basophils



Which types of cell INCREASE when there is an infection

granulocytes and monocytes



Which type of cells proliferate most rapidly during early infection?

neutrophils




***LEFT SHIFT to make more***

reduction in the number of circulating neutrophils

neutropenia

absolute increase in the number of eosinophils




cause?

eosinophilia




allergies




tissue with LOTS Of mast cells most susceptible

decrease in the number of eosinophils


cause?

eosinopenia




caused by migration of eosinophils to inflammatory site




cushings, stress, shock

increase in number of basophils


cause

basophilia




hyperthyroidism, acute infection, long term therapy with steroids




ovulation and pregnancy

increase in circulation of monocytes


cause

monocytosis




may be transient and not related to dysfunction




likely found with neutropenia


bacterial infections, TB listeriosis etc







decrease in numbers of circulating monocytes


cause

monoctyopenia


rare-not much known


hairy cell leukemia and prendisone therapy

Lymphocytosis is most closely related to

infection by a virus ex. EBV

Lymphocytopenia is most closely related to

neoplasms and immune deficiencies


destruction by drugs, viruses, or radiation


AIDS

acute, self limiting, neoplastic lymph proliferative clinical syndrome that is caused by the EBV

Infectious mono

The classic triad of symptoms for a pt with infectious mono

pharyngitis, lymphadenopathy, fever

Mono infects which cell type

B cells

Translocation between chromosome 9 and 22


98% of people with CML have tit



Philadelphia chromosome

What cell types are myeloid?


What cell types are lymphoid?

Leukemia that is rapid, most common in children, 91% survival rate and greater than 30% lymphoblasts and B cells

acute lymphatic leukemia ALL

Leukemia that is slow, most common in adults, 85% chance of survival, and develops in monoclonal B cells

chronic lymphatic leukemia


CLL

leukemia that is rapid, most common adult form, 24% survival rate, and primary cell type precursor myeloid cells

acute myeloid leukemia

Leukemia that is slow, found mostly in adults, with no cure, and the primary cell types are neutrophils, eosinophils or long. arise from a hematopoietic stem cell

chronic myeloid leukemia

disease characterized by it's progression from one lymph node to another leading to systemic symptoms and the presence of reed stein berg cells

Hodgkins lymphoma





disease characterized by multiple peripheral nodes, common to have extra nodal involvement, noncontiguous spread and rarely localized

non-hodgkin lymphoma

B cell tumor that is highly aggressive and the most common type of non-hodgkin lymphoma.




Fastest growing tumor in the human body




EBV found in 90% of the cases




MC type of lymphoma in children

Burkitt Lymphoma

Burkitt Lymphoma

enlarged lymph nodes that become palpable and tender

lymphadenopathy

adenopathy, mediastinal mass, splenomegaly, abdominal masses.




accompanied by fever, weight loss, night sweats and pruritus




paraneoplastic syndrome

Hodgkin lymphoma

Hodgkin lymphoma

generic term for a diverse group of lymphomas




linked to chromosomal translocations, viral and bacterial infections, environmental agents, immunodeficiencies, and autoimmune diseases

non-hodkgin lymphoma

decreased platelet count

thrombocytopenia



thrombocytopenia where IgG antibodies target platelet glycoproteins which then sequesters them from circulation

ITP
Immune thrombocytopenia purpura


*may lead to major hemorrhage

ITP


Immune thrombocytopenia purpura






*may lead to major hemorrhage

thrombotic microangiopathy in which platelets aggregate and cause occlusion of arterioles within the microcirculation.




Leading to platelet consumption or organ ischemia

thrombotic thrombocytopenia purport

thrombotic thrombocytopenia purport

complex, acquired disordered where clotting and hemorrhage simultaneously occur

DIC


disseminated intravascular coagulation




subacute hemorrrhage and diffuse microcirculatory thrombosis

disorder where the amount of activated thrombin exceeds the body's antithrombins and the thrombin does not remain localized

DIC




* leads to widespread ischemia, infarction, and organ hypo perfusion**

erythrocytes from the first incompatible fetus cause the mother's immune system to produce antibodies that affect the fetus of the subsequent incompatible pregnancies

Hemolytic disease of the newborn

The two types of hemolytic disease of the newborn




which is more severe?

RH incompatibility




ABO incompatability

increased bilirubin in neonates

icterous neonatorum




can be a result of hemolytic anemia of the newborn

disorder whereby mutation leads to the inability to maintain metabolic process when blood is injured.


due to drugs, faba, hypoemia

G6PD

a pt with G6PD that is undergoing repeated exposure to oxidative stressors will precipitate insoluble hemoglobin called

heinz bodies




*leads to hemolysis in the spleen*

disorder characterized by the presence of abnormal HgS

sickle cell anemia

Sickling of red blood cells in a pt with sickle cell is usually due to

deoxygenation and dehydration




low temp

disease caused by impaired rate of synthesis of the globin A and B chains

Thalassemia

chronic disease of the arterial system


-abnormal thickening and hardening of the vessel walls


-smooth muscle cells and collagen fibers migrate to the tunica interna

Arteriosclerosis

thickening and hardening of the arteries caused by accumulation of lipid-laden macrophages in the arterial wall




develops plaques




process occurring throughout the body

atherosclerosis

bleeding disorder in which clotting factors are missing




9/13/1 are the most common making up 90-95% of the bleeding disorders

hemophilia

factor 8 missing


xlinked recessive

Hemophilia A

factor 9 missing


x linked recessive

Hemophilia B -- christmas disease

factor 11 missing


autosomal recessive




*less severe

hemophilia C

autosomal dominant disorder


missing factor 8

Von Willebrand disease

disorder of platelet consumption in which anti platelet antibodies bind to the plasma membrane of platelets, causing platelet sequestration and destruction by mononuclear phagocytes in the spleen and other lymphoid tissues at a rate that exceeds the ability of the bond marrow tons produce

ITP