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64 Cards in this Set
- Front
- Back
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dendritic cells
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= 'professional APCs'
express MHC II and FcR on surface main inducers of primary Ab response skin dendritic cells = langerhans cells |
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plasma is made of
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91.5% water, 7% proteins
-> 55% alb, 38% globins, 7% fib also salts, lipids, enzymes, vitamins *plasma is 55% of blood |
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antithrombin III
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inactivates thrombin, IXa, Xa, and XIa
activated by binding to heparin |
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bradykinin leads to
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increased vasodilation
increased permeability increased pain (via the kinin cascade) |
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neoplasms associated with tuberous sclerosis
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astrocytoma
cardiac rhabdomyoma |
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neoplasms associated with acanthosis nigricans
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visceral malignancies of
-stomach, lung, breast, uterus |
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oncogenes
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c-myc: burkitt's
erb-B2: breast, ovary, gastric ras: colon L-myc: lung N-myc: neuroblastoma ret: MEN types II and III |
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tumor suppressor genes
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Rb: retinoblastoma, osteosarcoma
p53: Li-Fraumeni syndrome (etc) p16: melanoma APC: colon WT1: wilms tumor NF1, NF2: neurofibromatosis DPC: pancreatic DCC: colon |
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AFP
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hepatocellular carcinomas
non-seminomas of the testis [yolk sac tumor] |
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B-hCG
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hydatiform mole
choriocarcinomas gestational trophoblastic tumors |
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S-100
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melanoma
neural tumors astrocytomas |
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bombesin
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neuroblastoma
lung gastric |
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TRAP
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(tartrate resistant acid phos)
hairy cell leukemia |
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psammoma bodies
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PSaMMoma
papillary (thyroid) serous (ovary) meningioma mesothelioma |
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napthlene [aniline] dyes
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cause bladder transitional cell carcinoma
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lambert-eaton syndrome
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=antibodies at presynaptic Ca channels at NMJ (looks like MG)
seen in thymomas, SCLCs |
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primary tumors that metastasize to brain
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Lots of Bad Stuff Kills Glia
lung, breast, skin, kidney [RCC], GI **50% of brain tumors are from metastases |
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metastasis to bone
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PT Barnum Loves Kids
prostate, thyroid, testes, breast, lun, kidney *breast and prostate = #1 |
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diseases with target cells
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HALT
Hgb-C, a-splenia, liver disease, thalassemias |
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burr cells
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TTP/HUS
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micro hypo anemias
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IDA (low iron, high TIBC, low ferritin)
thalassemias lead poisoning sideroblastic anemia |
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macrocytic anemias
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B12/folate deficiency
drugs that block DNA synthesis -> sulfa drugs, AZT marked reticulocytosis |
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normo normo anemias
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acute hemorrhage
enzyme defects (G6PD, PK) RBC membrane defects (HS) BM disorders (aplastic, leukemia) hemoglobinopathies (SCA) autoimmune hemolytic anemia ACD (LOW TIBC, high ferritin, high marrow mac iron storage) |
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alpha thalassemia
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4 alpha globin genes
either a,a/a- (alpha thal 2) or a,a/-- a-/a- (trait/ alpha thal 1) a-/-- : HgbH disease --/-- = Hgb Barts |
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autoimmune WARM hemolytic anemia
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(IgG)
SLE, CLL, certain drugs [methlydopa] *all autoimmune hemolytic anemias are coombs positive |
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direct coombs
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anti-IgG added to pts RBCs
will agglutinate if there is IgG attached to pts RBCs (used to see if baby is suffering from mom's anti-Rh) |
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indirect coombs
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normal RBCs added to pts serum
will agglutinate if pts serum contains anti-RBC IgG (used to test mom for presence of anti-Rh antibodies) |
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autoimmune COLD hemolytic anemia
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(IgM)
seen in recovery from M. pneumo or in EBV |
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PNH
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intravascular hemolysis due to membrane defect
(RBCs sensitive to complement lysis) *high levels of urine hemosiderin |
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Bernard Soulier syndrome
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defect of plt ADHESION
(low levels GP Ib) |
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Glanzmann's thrombasthenia
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defect of plt AGGREGATION
(low GP IIb/IIIa) |
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HL
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Reed-sternberg cells (CD30, CD15)
localized group of nodes, contiguous spread "B" Sx: low grade fever, night sweats, wt loss mediastinal lymphadenopathy 50% of cases ass'd with EBV good Px if low RS, high lymphs biomodal age distribution |
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NHL
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ass'd with HIV, immunosuppression
multiple, PERIPHERAL nods extranodal involvement common non-contiguous spread non hyper-gammaglobluinemia fewer constitutional Sx peak = 20-40 yrs |
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nodular sclerosing HL
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65-75% of HL
more lymphs than RS excellent Px collagen banding, lacunar cells women > men: usually young adults |
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mixed cellularity
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high levels both RS and lymphs
intermediate Px 25% of HL |
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lymphocyte predominant
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6% of HL
much more lymphs than RS <35 year old males excellent Px |
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lymphocyte depleted
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rare
low levels of both types, but RS is higher compared to lymphs POOR Px older males w/disseminated HL |
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types of NHL
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small lymphocytic
follicular (small, cleaved cell) -> t(14:18), bcl2, most common diffuse large cell (80% B, 20% mature T) lymphoblastic (kids, immature T cells. VERY aggressive) Burkitt's |
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Burkitt's lymphoma
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type of NHL
t(8:14), c-myc oncogene 'starry-sky' appearance asociated w/EBC jaw lesion in Africa [endemic] usually B cells |
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auer rods
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peroxidase positive
seen in APML (M3) -> APML = t(15:17), treat with all-trans retinoic acid *in APML treatment, can release auer rods and cause DIC |
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types of ALL
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L1: small blasts w/scant cytoplasm. most common, best Px
L2: T cells, larger, more cytoplasm, worse Px, adults more L3: cells look like Burkitts, and has same Tx |
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cell cycle specific chemo
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MTX, 5-FU, 6-MP (antimetabolites)
etoposide bleomycin vinca alkaloids paclitaxel |
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cell cycle-nonspecific
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alkylating agents
antibiotics [doxorubicin, bleomycin, actinomycin] |
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ITP
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immune mediated destruction of plts by the spleen
increased megakaryocytes in BM ABSENCE of fragmented RBCs ->distinguish from microangiopathic anemia, TTP |
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TTP
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increased bleeding time, decreased plt count
purpura, fever, renal failure, microangiopathic hemolytic anemia, microthrombi high indirect bili, high LDH schistocytes, renal dysfxn |
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marker of primitive lymphs
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TDT [active when rearrangement of VDJ/TCR is occuring]
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coumadin + clarithromycin
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clarithromycin inhibts CYP450, so increased coumadin levels
leads to anticoagulation, hematuria |
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myeloproliferative disorders
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CML
PV myeloid metaplasia with myelofibrosis -> hematopoesis moves to spleen or liver ET (very rare tho) |
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thoracic duct drains
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everything but the R arm, R side of the chest, R side of the head
[the right lymphatic duct drains these] |
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chronic congestive splenomegaly
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usually ass'd with cirrhosis
spleen has thick capsule, many small scarred areas [Gamma-Gandy nodes] histo = fibrosis with hemosiderin and calcium deposition |
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uterine leiomyomas lead to what type of anemia?
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IDA [abundant blood loss during menstruation]
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embryonic hematopoesis
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3rd week in utero: yolk sac
2nd trimester: liver and spleen 3rd: central/peripheral skeleton adulthood: axial skeleton |
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drainage of short saphenous vein (lateral dorsum of foot)
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lymph nodes behind knee in the popliteal fossa
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lead poisoning
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colicky abd pain, headache, irritability, neuropathy
basophilic stippling, increased free RBC protoporphyrin microcytic anemia Tx: EDTA |
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prognosis of follicular lymphoma
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(overexpression of bcl-2)
slow, but relentless growth allows long survival but treatment is ineffective b/c of low mitotic activity |
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small, cleaved cell lymphoma
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=most common NHL t(14,18)
involves immunoglobulin chain site and bcl-2 |
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burkitt's lymphoma types
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common = t(8,14)
->myc on 8 and heavy Ig on 14 t(8,22): myc and lambda light Ig t(2,8): myc and kappa light Ig |
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associated with t(11,14)
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mantle cell lymphoma
multiple myeloma small (not cleaved) NHL ->bcl-1 and heavy Ig |
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drugs causing aplastic anemia
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NSAIDs, benzene, chloramphenicol
(the hypocellular BM fills w/fat) |
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weird coumadin side effect
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necrosis of skin btwn 3-10 days after therapy begins
lesions can progress to bullae mechanism is related to depletion of protein C |
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treatment of M3 AML can lead to
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DIC
due to release of auer rods |
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tingible body macrophages
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characteristic of benign reactive lymphadenitis
(lymph node is also tender, which suggests that it's benign) |
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primary Tx of CLL
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chlorambucil(a nitrogen mustard)
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the actual tumor cell in nodular sclerosing HL
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is the LACUNAR cell
should also see broad collagen bands and few RS cells |
