Pathology: Hematology Summary

Front 1

compare blood levels of bacterial vs. viral infections

Back 1

bacterial = high NEUTROPHILS ; viral = increase in LYMPHOCYTES

Front 2

what is progression from blast to neutrophil

Back 2

myeloblast, promyelocyte, myelocyte, metamyelocyte, band (seg), neutrophil

Front 3

how can you tell what the normal cellularity of bone marrow should be

Back 3

subtract age from 100 and +/- 10% and look for a trilineage maturation (all three are present in the process of maturing) -- 50 years old = 100 - 50 +/- 10% so between 40-60% celularity

Front 4

a boy with a long history of allergies (wheezing, hives, eggs, chronic rhinitis, severe eczema) what cells will be elevated in an acute flare up of wheezing

Back 4

eosinophils - eosinophils think ALLERGY

Front 5

a pt with round red blood cells that resemble spheres has a defect in what

Back 5

hereditary spherocytosis - defect in ankyrin

Front 6

what markers would you expect on T lymphs

Back 6

CD 2,3,4,5,7 - (also think CD4+ or CD8+)

Front 7

what markers would you expect on B lymphs

Back 7

CD 19, 20, 24 ish

Front 8

what markers would you expect on NK cells

Back 8

CD 56 usually

Front 9

pt presents bruising easily and petechiae all over his skin what is problem

Back 9

platelet formation problem

Front 10

know normal CBC values

Back 10

!!

Front 11

monocytes and macrophages - which is in tissue, which differentiates into what

Back 11

monocytes are in blood --> diff to macrophages in tissue (phagocytosis, AG presentation, chronic inflamm)

Front 12

under age 15 ; 85% pale, petechiae, fatigue ; B cell origin ; incr. downs syndrome ; CD19+ mostly (sometimes its CD5+)

Back 12

ALL

Front 13

20% blasts in marrow ; many auer rods (high incidence of DIC), t(15,17)

Back 13

M3 - AML (promyelocytic) ; tx with Vitamin A

Front 14

auer rods present, t(8,21)

Back 14

M2 - FAVORABLE Dx

Front 15

which AML has incr association with Down syndrome

Back 15

M7

Front 16

which AML has gum infiltration

Back 16

M5

Front 17

Eo associated with inv (16), rarely Auer rods ; adults

Back 17

AML - M4Eo (good prognosis)

Front 18

less than 10% blasts ; baso and eosino-philia (lots of them), splenomegaly ; insidious presentation ; t(9,22) ; myeloid cells in blood

Back 18

CML

Front 19

incr. WBC count ; lymphadenopathy and hepatosplenomegaly ; smudge cell, CD19, 20 and 5 ; elderly get this ; small lymphocytes ; prolymphocytic transformation

Back 19

BAD PROGNOSIS OF CLL - dead in a year

Front 20

incr. WBC count ; lymphadenopathy and hepatosplenomegaly ; smudge cell, CD19, 20 and 5 ; elderly get this ; small lymphocytes ; richter transformation

Back 20

REALLY BAD PROGNOSIS OF CLL (--> diffuse large B cell lymphoma) - dead in a year

Front 21

tartrate resistant acid phosphatase (TRAP) ; large spleen ; "dry tap" ; mostly men ; CD11c+

Back 21

cell-hair like projections --> HAIR CELL LEUKEMIA

Front 22

JAK/STAT - low epo ; incr. RBCs, grans and pl's , hyperviscous and HTN of blood, itchy in shower (aquagenic pruritis) ; vascular distention and pl dysfunction --> bleeding ; DVT, MI ; poor oxygen delivery to tissue (tinnitis, vertigo, visual disturbances)

Back 22

polycythemia vera

Front 23

BCL2 (in germinal center B cells) ; nodular growth pattern ; centrocytes/centroblasts ; t(14,18) ; "paratrabecular" ; generalyzed lymphadenopathy

Back 23

follicular lymphoma

Front 24

incr. large cells --> mitosis (30% extra-nodal) ; BCL6 ; t(14,18) ; EBV / HIV ;

Back 24

large B cell lymphoma

Front 25

EBV (endemic in africa) ; high mitotic index and numberous apoptotic cells ; "starry sky" pattern ; c-myc t(8,14)

Back 25

burkitt lymphoma (EBV in all endemic cases ; 15-20% of sporadic and 25% of HIV cases)

Front 26

bones appear "punched out" ; "flame cell" ; "mott cells" ; "russel bodeis and Dutcher bodis" -- high level of M protein ; CRAB - hypercalcemia, renal dysfunction, anemia, chronic fx's ; Bence Jones protein ; serum electrophoresis with a spike ; "plasma cell dysphasia"

Back 26

multiple myeloma

Front 27

high levels of igm lead to hyperviscosity in blood ; most commonly in association with lymphoplasmocytic lymphoma

Back 27

waldenstrom macroglobulinemia

Front 28

t(11,14) ; BCL1 ; poor prognosis

Back 28

mantle cell

Front 29

MALTomas - chronic inflammation (H. pylori)

Back 29

marginal cell lymphoma

Front 30

reed sternberg cells ; "owl eyes"

Back 30

hodgkin's dz (lymphoma)

Front 31

CD4+ T cells ; 3 stages of skin lesions - inflamm premycotic phase ; plaque phase ; tumor phase ; epidermis and dermis are invaded by neoplastic T cells ;

Back 31

mycoses fungoides

Front 32

MC hodgkin's - CD15+, CD30+, CD45-

Back 32

nodular sclerosis hodgkin's dz

Front 33

20-25% hodgkin's - EBV 70% of cases (in reed sternberg cells) ; CD15 and 30

Back 33

mixed cellularity hodgkin's dz

Front 34

uncommon HD ; 40% associated with EBC - CD15+, CD35+ ; CD45 - very good to excellent prognosis

Back 34

lymphocyte rick HD

Front 35

least common HD - EBV 90% ; very bad prognosis ; CD15+, CD30+, CD45-

Back 35

lymphocyte-depletion HD

Front 36

NO EBV associton - uncommon "nonclassical" ; CD20+ and BCL6+ ; CD15- and CD30- ; excellent prognosis

Back 36

lymphocyte predominance type HD

Front 37

laminations seen grossly and microscopically which represent pale platelet and fibrin deposits alternating with darker red rbc layers

Back 37

lines of zahn

Front 38

Gelatinous with dark red dependent portion (red cells have settled by gravity) and yellow “chicken fat” upper portion ; Not attached to underlying wall ;No lines of Zahn ; Important to know difference to determine cause of death

Back 38

postmorten clots

Front 39

difference between arterial and venous thrombi

Back 39

arterial - grow retrograde from point of attachement ; venous - grow toward heart (in direction of blood flow) and they form a "cast" of lumen ;

Front 40

AD disorder ; hypercoagulability state ; this factor is resistant to cleavage by protein C --> venous thrombi ; increase in factor 5

Back 40

leiden V mutation

Front 41

cannot inactivate factors V and VIII ; AD with complete penetrance ; hypercoagulability

Back 41

protein C deficiency (protein C controls formation of thrombin in presence of cofactor protein S)

Front 42

not inactivate factors V and VII ; AD inheritance ; cofactor of protein C ; mutations --> quantitative or qualitative deficiences ; hypercoagulability

Back 42

protein S deficiency

Front 43

what causes warfarin skin necrosis

Back 43

protein S and C deficiencies

Front 44

example of primary (inherited) disorders which cause clotting

Back 44

factor V leidin ; prothrombin gene mutation ; homocysteinemia ; antithrombin deficiency ; protein C and S deficiency

Front 45

example of secondary (acquired) disorders which cause clotting

Back 45

HIT aand APA

Front 46

things that cause bleeding diseases

Back 46

vessel wall abnormalities ; platelet quality (ITP - acute/chronic and TTP/HUS) ; platelet quality (bernard-soulier, glanzman thrombosthenia, aspirin-acquired) ; clotting factor disorders (vWdz, hemophilia A and B) and DIC

Front 47

t(11,14)

Back 47

mantle cell - bcl1

Front 48

t(15,17)

Back 48

M3

Front 49

t(8,21)

Back 49

M2 - favorable!

Front 50

t(9,22)

Back 50

philly - CML

Front 51

inv(16)

Back 51

EoM4 - good prog

Front 52

JAK/STAT

Back 52

poly vera

Front 53

BCL2

Back 53

follicular (t14,18)

Front 54

BCL1

Back 54

mantle cell

Front 55

BCL6+

Back 55

large B cell