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114 Cards in this Set
- Front
- Back
Causes of eosinophilia =
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1) neoplasm
2) asthma 3) allergy 4) collagen vascular dz 5) parasites |
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Which leukocyte has a bilobate nucleus, makes histaminase & arylsulfatase, and is highly phagocytic for Ag:Ab complexes?
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eosinophils
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Which type of cell resembles basophils structurally and functionally, but is found in tissue instead of blood, and binds IgE to its membrane?
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mast cells - mediate allergic reaction
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Which leukocyte mediates the acute inflammatory response, is multi-lobate, and phagocytic?
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neutrophil
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What can be found inside a neutrophil granule/lysosome?
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1) myeloperoxidase
2) hydrolytic enzymes 3) lactoferrin 4) lysozyme |
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Which type of blood cell has an eccentric nucleus, "clock face" chromatin, lots of RER, and a well-developed Golgi?
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plasma cell - makes lots of Ab specific to a particular Ag
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What type of cell phagocytizes bacteria, cellular debris, old RBCs, and can present Ag on MHC II?
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macrophages - differentiated from monocytes, activated by gamma IFN
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I am an antigen presenting cell. I have MHC II and Fc receptor on my surface. I induce the primary Ab response. What am I?
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dendritic cell - called Langerhans cells on skin
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What do Protein C & S do?
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inactivate Va & VIIIa
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In the extrinsic pathway, Factor VIIa + ___ activate Factor X.
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tissue factor
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In the intrinsic pathway, Factors ___a + ___a activate Factor X.
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IXa + VIIIa
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Factor Xa + ___ cleave prothrombin to thrombin.
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Va
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Thrombin cleaves ___ to ___, then Factor ___a will help form a cross linked clot.
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fibrinogen, fibrin, XIIIa
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What does antithrombin III do?
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inactivates: thrombin, IXa, Xa, XIa
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What does tPA do?
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generates plasmin to cleave fibrin (thrombolytic agent)
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What effects does bradykinin have?
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1) inc. pain
2) inc. vasodilation 3) inc. vascular permeability |
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Metaplasia =
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replacement of 1 cell type by another, often 2ndary to irritation or environmental exposure (smoker's trachea)
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Dysplasia =
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abnormal cell growth and maturation w/loss of orientation, shape, and size, often neoplastic but still reversible
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Anaplasia =
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abnormal cells lacking differentiation, look like primitive cells of same tissue but can be undifferentiated malignant neoplasm
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Neoplasia =
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CLONAL proliferation that is uncontrolled and excessive
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Tumor grade refers to:
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histology, degree of differentiation, # mitoses per hpf
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Tumor stage refers to:
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metastases, degree of spread based on site and size of lesion, more PROGNOSTIC value than grade
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A papilloma is:
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benign epithelial tumor
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A hemangioma is:
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benign blood vessel tumor
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An angiosarcoma is:
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malignant blood vessel tumor
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"Carcinoma" implies ___ origin.
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epithelial
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"Sarcoma" implies ___ origin.
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mesenchymal (bone, muscle, fat, blood vessels)
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What neoplasms are associated w/Down syndrome?
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ALL, AML
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What neoplasms are associated w/xeroderma pigmentosum and albinism?
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melanoma, basal cell CA, squamous cell CA of skin
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What neoplasm is associated w/chronic atrophic gastritis and pernicious anemia?
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gastric ACA
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What neoplasms are associated w/tuberous sclerosis? (recall: cortical hamartomas, facial angiofibromas, seizures, mental retard)
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astrocytoma, cardiac rhabdomyoma
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What neoplasm is associated w/actinic keratosis?
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squamous cell CA of skin
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What neoplasm is associated with Barrett's esophagus?
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esophageal ACA
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What is Plummer-Vinson syndrome and what neoplasm is it associated with?
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P-V syndrome is iron deficiency --> anemia, atrophic glossitis, esophageal webs; associated w/squamous cell CA of esophagus!
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What neoplasm is associated w/ulcerative colitis?
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colon ACA
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What neoplasms are associated w/Paget's bone disease?
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osteosarcoma, fibrosarcoma
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An immunocompromised state predisposes one to which kind of neoplasm?
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malignant lymphomas
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Having AIDS predisposes one to which neoplasms?
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NHL, Kaposi's sarcoma
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Having an autoimmune disease, such as Hashimoto's or myasthenia gravis, predisposes one to which neoplasm?
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benign and malignant thymomas
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Acanthosis nigricans (hyperpigmented, thick skin) predisposes a person to which neoplasms?
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visceral malignancies, like stomach, lung, breast, uterus
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abl
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CML
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c-myc
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Burkitt's lymphoma
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bcl-2
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follicular and undifferentiated lymphomas
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erb-B2
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breast, ovarian, gastric CA
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ras
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colon CA
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L-myc
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lung tumor
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N-myc
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neuroblastoma (Homer-Wright rosettes)
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ret
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- MEN II (parathyroid, medullary CA of thyroid, pheochromocytoma)
- MEN III (medullary CA of thyroid, pheochromocytoma, mucosal neuromas) |
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Rb
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13q - retinoblastoma, osteosarcoma
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BRCA-1, 2
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17q, 13q - breast and ovarian CA
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p53
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17p - most human cancers, Li-Fraumeni syndrome
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p16
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9p - melanoma
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APC
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5q - colorectal CA
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WT1
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11q - Wilm's tumor
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NF1
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17q - neurofibromatosis type 1 (cafe au lait spots, Lisch iris hamartomas, scoliosis, pheochromocytoma)
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NF2
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22q - neurofibromatosis type 2 (bilateral acoustic schwannomas, optic gliomas, juvenile cataracts)
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DPC
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18q - pancreatic CA
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DCC
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18q - colon CA
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PSA (prostatic acid phosphatase)
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prostate-specific antigen; screen for prostate CA (but first use the digital technology because it's the most cost-effective screening method!)
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CEA (carcinoembryonic antigen)
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very nonspecific, made by 70% of pancreatic and colorectal CA, also gastric and breast CA
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a-fetoprotein
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hepatocellular CA, yolk sac tumor
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b-hCG
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hydatidiform moles, choriocarcinoma, gestational trophoblastic tumors (also some germinomas make b-hCG)
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CA-125
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ovarian, malignant epithelial tumors
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S-100
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melanoma, astrocytoma, neural tumors
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alkaline phosphatase
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mets to bone, obstructive biliary disease, Paget's bone disease
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bombesin!!
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neuroBLASToma, lung, gastric CA
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TRAP (tartrate resistant acid phosphatase)
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hairy B-cell leukemia
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Psammoma bodies can be seen in which malignancies?
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1) papillary serous cystadenocarcinoma of thyroid
2) serous cystadenocarcinoma of ovary 3) meningioma 4) malignant mesothelioma |
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HTLV-1
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adult T-cell leukemia
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HBV, HCV
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hepatocellular carcinoma
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EBV
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Burkitt's lymphoma, nasopharyngeal carcinoma
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HPV
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cervical carcinoma, penile/anal carcinoma
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HHV-8
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Kaposi's sarcoma, body cavity fluid B-cell lymphoma
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aflatoxins
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hepatocellular carcinoma
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vinyl chloride
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liver angiosarcoma (recall: ugly bloody picture from QBank)
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CCl4
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liver centrilobular necrosis and fatty change
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nitrosamines
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esophageal and gastric CA
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cigarette smoke
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laryngeal and lung CA
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asbestos
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malignant mesothelioma and bronchogenic CA
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arsenic
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squamous cell CA of skin
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naphtalene (aniline) dyes
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bladder transitional cell CA (can also be caused by phenacetin, smoking, cyclophosphamide)
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alkylating agents
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blood (leukemia)
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ACTH or ACTH-like peptide
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small cell CA of lung; Cushing's syndrome
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ADH
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small cell CA of lung, intracranial neoplasms; SIADH (tx with demeclocycline)
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PTH-related peptide, TGF-b, TNF-a, IL-1
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squamous cell CA of lung, renal cell CA, breast CA, multiple myeloma, lytic bone metastasis; hypercalcemia
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erythropoietin
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renal cell CA, hemangioblastoma
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antibodies against presynaptic Ca channels at nmj
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thymoma, small cell CA of lung; Lambert-Eaton syndrome of muscle weakness
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hyperuricemia
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leukemia, lymphoma (tumor lysis syndrome); gout, urate nephropathy (radiolucent)
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Tumor mets to brain:
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lung, bone, melanoma, renal cell CA, GI
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Tumor mets to liver:
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colon > stomach > pancreas > breast > lung
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Tumor mets to bone:
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BREAST, lung, thyroid, PROSTATE, kidney, testes
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Blastic bone mets =
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prostate OR breast
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Cancer is the ___ leading cause of death in the US.
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2nd - heart disease is 1st
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___ cancer is the leading cause of cancer death in the US.
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Lung
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Spherocytes could mean:
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hereditary spherocytosis, autoimmune hemolysis
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Macro-ovalocytes:
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megaloblastic anemia, marrow failure
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Helmet cells, schistocytes:
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traumatic hemolysis, DIC
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Teardrop cell:
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myelometaplasia with myelofibrosis (marrow fibrosis)
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Acanthocyte "spur cell":
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liver disease (abetlipoproteinemia)
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Target cell:
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HbC disease (mild hemolytic anemia), aspenia, liver disease, thalassemia
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Poikilocytes:
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TTP, HUS, microvascular damage, DIC
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Burr cell:
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Kidney disease (TTP, HUS)
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High serum bilirubin, pigment gallstones, and high reticulocyte count indicate (generally speaking) ___ anemia.
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hemolytic
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How do you determine if a patient's hemolysis is due to an autoimmune cause?
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Direct Coomb's test: take patient's RBCs and add anti-Ig Ab --> if RBC agglutinate, means RBCs covered with Ig and it is autoimmune hemolysis
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After you've determined the RBC hemolysis is autoimmune, what do you do to narrow down the differential?
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Agglutinin test: warm agglutinin positive (IgG) means chronic anemia seen in diseases like lupus and CLL or on meds like methyldopa; cold agglutinin positive (IgM) means an acute anemia seen during recovery from Mycoplasma pneumoniae or infectious mononucleosis
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Erythroblastosis fetalis =
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Rh(-) mother's anti-Rh antibodies attack Rh(+) baby's RBCs
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What is the indirect Coomb's test?
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take patient's serum and add normal RBCs --> if these agglutinate, means patient serum had anti-RBC immunoglobulins
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Hereditary spherocytosis =
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intrinsic defect in RBC membrane (problem with spectrin, ankyrin) --> less membrane --> extravascular hemolysis; don't see central pallor, have high MCHC and RDW
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How do you confirm a suspected diagnosis of hereditary spherocytosis?
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osmotic fragility test - this is not autoimmune hemolysis so it's Coomb's negative
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Paroxysmal nocturnal hemoglobinuria =
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intrinsic RBC membrane defect (missing CD55, CD59) --> susceptible to complement lysis --> urine hemosiderin
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Microangiopathic anemia =
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intravascular hemolysis seen in DIC, TTP, HUS, lupus, malignant HTN; see schistocytes
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Causes of DIC:
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1) OBSTETRIC complications
2) sepsis 3) transfusion 4) trauma 5) malignancy 6) acute pancreatitis 7) nephrotic syndrome |
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Prolonged PT, prolonged PTT, low platelets, high fibrin split products (D-dimers) =
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DIC
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Microthrombi, global consumption of platelets and clotting factors =
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DIC
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