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154 Cards in this Set
- Front
- Back
What is a neutrophil? |
The phagocyte (has antimicrobials and most abundant)
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What is Eosinophil?
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The parasite destroyer, Allergy inducer
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What is a basophil?
what receptor does it have? what does it release? |
The allergy helper (IgE receptor => histamine release)
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What is a monocyte?
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The destroyer => MP (hydrolytic enzymes, coffee- bean nucleus)
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What is a lymphocyte?
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The warrior => T,B, NK cells
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What is the platelet?
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The clot
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What is a blast?
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baby hematopoietic cell
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What is band?
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baby neutrophil
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What does high WBC and < 5% blast cell tells you?
where is this seen? why? |
leukemoid reaction,
seen in burn pts (extreme demargination looks like leukemia) |
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What does high WBC and high PMNs tell you?
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stress demargination
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What does high WBC and >5% blasts tell you?
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leukemia
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What does high WBC and B cells tell you?
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bacterial infection
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What does high WBC and bands cells tell you?
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left shift => have infection
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What diseases have high eosinophils?
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"NAACP"
Neoplasm Addisons disease (no cortisol => relative eosinophillia) Allergy/Asthma Collagen vascular diseases Parasites |
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What diseases have high monocytes (>15%)
give a brief description of each |
"STELS"
Syphillis: chancer, rash, warts TB: hemoptysis, night, sweats EBV: teenager sick for a month Listeria: baby who is sick Salmonella: food poisoning |
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What do high retics (>1%) tell you?
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RBC being destroyed peripherally
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What do low retics (<1%) tell you?
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bone marrow not working right
(decrease production) |
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Poikilocytosis
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different shapes
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Anisocytosis
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Different sizes
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What is the RBC lifespan?
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120 days
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What is the platelet lifespans?
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7 days
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What does -penia tell you?
what is it usually due to? |
low levels
(usually due to virus or drugs) |
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What does -cytosis tell you?
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high levels
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What does -cythemia tell you?
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high levels
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What is the difference between plasma and serum?
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plasma: no RBC
serum: no RBC or fibrinogen |
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What is chronic Granulomatous Disease?
deficiency what does this lead to? test |
NADPH oxidase deficiency => recurrent staph/aspergillus infections
(Nitroblue Tetrazolium stain negative) |
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What is Chediak Higashi
pathogenesis |
Lazy lysosome syndrome:
lysosomes are slow to fuse around bacteria. |
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What causes a shift to the right in the Hb?
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"All CADETs face right"
all are increased (CO2, Acid/Altitude, 2-3 DPG Excercise, Temp) except for pH |
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how does CO poison Hb?
presentation (2) |
Competitive inhibitor of O2 on Hb => cherry-red lips, pinkish skin hue
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how does cyanide poison Hb?
presentation |
Non-competative inhibitor of O2 on Hb => almond breath.
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What is Met Hb?
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Hb with Fe3+
(Ferrous (Fe2+) and ferric (Fe3+)) |
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What is Acute intermittent Phorphyria?
what are increase (3) presentations (3) |
increase prophyrin, urine delta-ALA, porphobilinogen
=> abdominal pain, neuropathy, red urine |
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What is porphyria cutanea tarda?
presentation test |
sunlight=> skin blisters with porphyrin deposits,
wood's lamp =orange-pink |
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What is erythrocytic protoporphyria?
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prophria cutanea tarda in babies
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What is sickle cell disease?
Hb etiology presentation and when would they have this? protection |
Homozygous HbS: (βglu6-> val)
=> vaso-occlusion, necrosis, dactylitis (painful fingers/toes) at 6 mo protects against malaria |
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What is Sickle cell trait?
Hb presentation occupation |
Heterozygous HbS
=> painless hematuria, sickle with extreme hypoxia (cant be a pilot, fireman, diver) |
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What is MPO deficiency cause?
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Catalase + infection
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Hb C disease:
etiology presentation |
(βglu6 -> lys)
still charged => no sickling |
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What is α-thalassemia?
1 deletion: presentation 2 deletion: presentation 3 deletions: Hb, and presentation 4 deletions: Hb, presentation |
1 deletion: Normal
2 deletion: "trait": microcytic anemia 3 deletions: hemolytic anemia, hb= H = β4 4 deletions: hydrops fetalis, Hb Bart = γ4 |
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β-thalessemia: # of deletions, name, describe, presentation if any
minor: major: |
minor: 1 deletion "β minor": increase Hb A2 and HbF
major: 2 deletions "trait/intermedia/major": only HbA2 and HbF => hypoxia at 6 months |
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cooley's anemia
where is this seen describe presentation |
See with β thalassemia major
(no HbA => excess RBC production) baby making blood from everywhere => frontal bossing hepatosplenomegally, long extremeties |
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What is Virchow's triad?
3 definitions |
thrombosis risk factors:
hypercoagubility "sticky" vessel wall damage "escapes" Turbulent blood flow "slow" |
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What does acute hypoxia cause?
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shortness of breath
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What does chronic hypoxia cause?
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clubbing of fingers/toes
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What is intravascular hemolysis?
what would be decreased and why? |
RBC destroyed in blood vv.
-> low haptoglobin (binds free floating Hb) |
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What is extravascular hemolysis?
why? presentation |
RBC destroyed in spleen
(problem w/ RBC membrane) => splenomegally |
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What enzymes need lead (Pb)?
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δ-ALA dehydrase
Ferrochelatase |
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What does EDTA bind?
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X2+
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What disease has a smooth philthrum?
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Fetal alcohol syndrome
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What disease has a long philthrum?
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Williams's
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What 2 disease has sausage digits?
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Pseudo-hypoparathyroidism, psoriatic arthritis
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What disease has 6 fingers?
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Trisomy 13 (patau's syndrome)
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What disease has 2-jointed thumbs?
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Diamond-blackfan
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What disease has painful fingers
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Sickle cell disease
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What are the Microcytic Hypochromic anemias?
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"Fast Lead"
Fe deficiency Anemia of chronic disease Sideroblastic Anemia α-Thalassemia β- Thalassemia Pb poisoning |
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Microcytic Hypochromic anemias:
Fe deficiency what is increased? presentation how does one get it |
increase TIBC,
menses, GI bleed, Koilonychia |
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Microcytic Hypochromic anemias: Anemia of chronic disease
name clue |
anemia of chronic inflammation
decrease TIBC |
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Microcytic Hypochromic anemias: Sideroblastic Anemia
how is it acquired? what is increased/decreased? |
decrease δ-ALA synthase,
blood transfusion |
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Microcytic Hypochromic anemias: α- Thalassemia
who is at risk Ch # |
AA, Asian (Chromosome 16 deletion)
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Microcytic Hypochromic anemias: β-Thalassemia
who is at risk Ch # |
Mediterraneans (Chr. 11 point mutation)
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What are the Megaloblastic anemias?
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Vitamin B12 deficiency
Folate deficiency Alcohol |
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Megaloblastic anemias: Vitamin B12 deficiency
name 4 etiologies |
Tapeworms, vegans, type A gastritis, pernicious, anemia
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Microcytic Hypochromic anemias: Pb poisoning
what enzyme are decreased? xray diet |
▼δ-ALA dehydrogenase, ▼ ferrochelatase,
x-ray blue line, eating old paint chips |
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Megaloblastic anemias: Folate deficiency
how is it acquired presentation |
Old food
glossitis |
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Megaloblastic anemias: Alcohol
syndrome presentation |
Fetal alcohol syndrome
smooth philthrum, stuff doesn't grow |
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What are the Intravascular Hemolytic anemias?
describe each anitbody? |
IgM
G-6PD deficiency: Sulfa drugs, moth balls, fava beans, sudden drop in Hb Cold autoimmune: mononuclosis, mycoplasma infections, RBC agglutination |
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G-6PD deficiency
type of hemolytic anemia etiology (3) presentation |
intravascular Hemolytic anemias
Sulfa drugs, moth balls, fava beans sudden drop in Hb |
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Intravascular Hemolytic anemias: Cold autoimmune
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Mononucleosis, mycoplasma infection, RBC agglutination.
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What are the 4 Extravascular Hemolytic anemias?
what is the antibody? |
IgG
Spherocytosis Warm autoimmune Paroxysmal cold autoimmune Sickle cell anemia |
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Extravascular Hemolytic anemias: antibody
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IgG
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Extravascular Hemolytic anemias: Spherocytosis
pathogenesis test |
Defective spherin or ankyrin, + osmotic fragility test
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Extravascular Hemolytic anemias: Warm autoimmune clues
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Anti-Rh Ab, dapsone, PTU, anti-malarials, sulfa drugs.
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Extravascular Hemolytic anemias: Paroxysmal cold autoimmune clues (2)
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Bleeds after cold exposure, Donath-Landsteiner Ab
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Sickle cell anemia
type of hemolytic anemia x-ray complication presention |
Extravascular Hemolytic anemia
Crew haircut x-ray avascular necrosis of femur short fingers |
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What are the Production anemias?
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Diamond-Blackfan
Aplastic anemia |
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Production anemias: Diamond-Blackfan clues (2)
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No RBC, 2-jointed thumbs
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Production anemias: Aplastic anemia clues
presentation etiology (5) |
Pancytopenia
autoimmune, benzene, AZT, CAM, radiation |
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What is Basophillic Stippling?
what does it mean? what type of anemia will one see this? |
Lots of immature cells,
↑mRNA (Pb poisoning) |
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Bite cell:
another name for a bite cell what is it? disease |
basket cell
Unstable Hb inclusions (G6-PD deficiency) |
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Where would one see Burr? (3)
another name? |
Echinocyte
Pyruvate kinase deficiency, Liver dz, Post-splenectomy |
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where would one see a Cabot's ring body? (2)
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Vitamin B₁₂ deficiency, Pb poisoning
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What is Doehle body?
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PMN leukocytosis (infection, steroids, tumor)
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Drepanocyte
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Sickle cell anemia
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Helmet cell
what is this what does it mean? where would one see this? (3) |
Fragmented RBC
Hemolysis: DIC, HUS, TTP |
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heinz body
what is it where would one see it? |
Hb precipitates and sticks to cell membranes
(G-6PD deficiency) |
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Howell-jolly body
what is it? where would one see it? (3) |
Spleen or bone marrow should have removed nuclei fragments
hemolytic anemia, spleen trauma, cancer |
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Pappenheimer body
what is it? where would one see it? |
Fe ppt inside cell
(sideroblastic anemia) |
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Pencil cell
another name disease |
cigar cell
Fe deficiency anemia |
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Rouleaux formation
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multiple myeloma
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Schistocyte
what is it? where would one see it? |
Broken RBC
(DIC, artificial heart valves) |
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Sideroblast
what is it? how is it acquired? |
Macrophages pregnant with Fe
(genetic or multiple transfusions) |
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Spherocyte
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Old RBC
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Spur cell
disease another name for this |
Lipid bilayer dz
acanthocyte |
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Stomatocyte is found in what disease?
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Liver dz
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Target cell:
another name for target cell what does it mean? what diseases would one see this? |
Dacrocyte
Less Hb Thallasemias or Fe deficiency |
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Tear drop cell
another name for tear drop cell? where would one see this? (2) |
Dacrocyte
RBC's squeezed out of marrow hemolytic anemia, bone marrow cancer |
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What is a clotting cascade?
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How you stop bleeding
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What do platelet problems cause?
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Bleeding from skin and mucosa
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What do clotting problems cause?
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bleeding into cavities
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What 2 diseases that causes increased PTT and bleeding time?
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Von willebrand disease and lupus
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What is Bernard-Soulier?
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Baby with bleeding from skin and mucosa, BIG platelets (low GP1b)
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what is Glanzmann's
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Baby with bleeding from skin mucosa ( low GP2b3a)
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How dose Factor 13 deficiency present?
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Umbilical stump bleeding (1st time baby has to stabilize a clot)
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What is Factor V leiden?
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Protein C can't break down Factor 5 => more clots
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How does von Willebrand Disease present?
what are the 3 types, describe each which one has a test? |
Presents as heavy menstrual bleeding
Type 1 (AD): ⇩VWF production Type 2 (AD): ⇩ VWB activity ( + Ristocetin aggregation test) Type 3 (AR): No VWF |
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What is Hemophilia A?
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Defective Factor 8 (< 40% activity) => bleed into cavities (head, abdomen, etc.)
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where do Hemophillia bleed?
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bleed into joints (knee, etc.)
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What is Hemophilia B?
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Factor 9 deficiency => bleed into joints (knee, etc.)
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What diseases have low LAP?
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CML, PNH
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What has a high LAP?
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Leukemoid reaction
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What is the difference between acute and chronic leukemias
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Acute: started in bone marrow, squeezes RBC out of marrow
Chronic: started in periphery, not constrained => will expand |
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What is the difference between myeloid and lymphoid leukemias
what test should be ordered? |
Myeloid: ⇧RBC, WBC, platelets, MP (⇩lymphoid cells) => bone marrow biopsy
Lymphoid : ⇧NK, T, B cells (⇩ myeloid cells) => do lymph node biopsy |
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What defines ALL?
age and sex test (2) |
<15 y/o males, bone pain
PAS stain +, TdT+ |
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What defines AML?
age and sex stain cell presentation |
15-30 y/o males
sudan stain Aure rods |
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What defines CML?
age and sex translocation gene what is increased/decreased? |
30-50 y/o females
t(9,22) "philadelphia chromosome" bcr-abl ⇩LAP |
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What defines CLL?
presentation biopsy |
>50 y/o males with lymphadenopathy
"soccer ball" nuclei and smudge cell |
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What defines Hodgkin's lymphoma?
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EBV, may have Reed-Sternberg cells
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What are the B cell Non-Hodgkin's lymphomas
translocation gene biopsy if any subtypes |
follicular: t(14,18), bcl-2
Burkitt: t(8,14), c-myc, starry sky MP American kids: abdominal mass African kids: jaw mass |
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What are the T cell Non-Hodgkin's lymphomas?
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Mycosis Fungoides: total body rash
Sezary syndrome: cerebriform cells |
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What is Polycythemia Rubra vera?
what is increased? what is decreased? disease association presentation |
Hct >60%
⇩Epo Budd-chiari plethora and "puritis after bathing" |
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What is Essential Thrombocythemia?
lab stain decreased/increased? |
Very high platelets
stainable Fe ⇩c-mpl |
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Myelofibrosis
cells biopsy presentation |
Megakaryocytes
fibrotic marrow => teardrop cells extramedular hematopoiesis |
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What do plasma neoplasms produce a lot of?
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antibody
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Waldestrom Macroglobulinemia
Ig presentation |
IgM
hyperviscous |
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Monoclonal Gammopathy of Undertermined Significance
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Old person with gamma spike
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Multiple Myeloma
Ig urine peripheral smear x-ray |
Serum M protein (IgG)
urine bence-jones protein rouleaux punched-out lesions |
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Heavy chain Disease
what Ig is increased? |
⇧Ig A
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Histocytosis X
(4 clues) |
kid with eczema, skull lesions, diabetes insipidus, exopthalmos
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What does the coombs test tell you?
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Ab involved
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What does the direct coombs test tell you?
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On surface => hemolytic anemias
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What does the indirect coombs test tell you?
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In serum
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What is type and cross?
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You know you can use that blood, save it for specific pt.
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What is type and match?
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type it and wait
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What is forward typing?
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Uses Antibody to detect Ag
"Fabulous" |
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What is backward typing?
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Uses Ag to detect Antibody
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Type A blood
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Have A antigen
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Type AB blood (2)
type of recipient/donor |
have both antigen
universal recipient |
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Type O blood
type of recipient/donor |
have no antigens, universal donor
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Rh+
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Has D antigen
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Rh-
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Does not have D antigen
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What is hemolytic disease of the new born
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Rh- Mom's placeta tears, 100cc baby's blood sees Mom/produces Ab, attacks fetus
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What is Rhogam?
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Anti-D IgG
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When do you give rhogam
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1st dose: 28 week gestation (of 2nd child)
2nd dose: 72 hrs post-delivery (Rh+ baby) |
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What is the most common transplant?
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blood
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Syngenic transplant
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twin to twin
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autograft
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self to self transplant
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allograft
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human to human transplant
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Xenograft
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1 species to another species
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hyperacute rejection
time duration causes |
within 12 hrs
(preformed Ab) |
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Acute rejection
duration cells |
4 days to years later
(T-cells, MP) |
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Chronic rejection
duration due to what? |
>7 days
(Fibroblasts) |
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Graft vs. Host disease
etiology what cells are responsible? |
Bone marrow transplants reject
(Tk, MP) |
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What are immunoprivileged sites?
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Sites that have no lymphatic flow => no Ag => easy to transplant (brain, cornea, thymus, testes)
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What is INR?
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Measured PT/Control PT
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