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86 Cards in this Set
- Front
- Back
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intrinsic pathway tested with
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PTT
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extrinsic pathway tested with
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PT
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extrinsic pathway starts with factor __ getting activated by ___
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factor VII activated by tissue factor
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intrinsic pathway starts with factor ___ getting activated by ___
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factor XII activated by collagen, basement membrane, activated platelets, or kininogen
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proteins C and S inhibit factor ___
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VIIIa, Va
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thrombomodulin activates ___ forming ___, which then combines with ___
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thrombomodulin activates protein C, forming APC, which then combines with protein S
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in addition to initiating the intrinsic pathway of the coagulation cascade, factor XIIa (Hageman factor) does what?
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converts prokallikrein to kallekrein
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kallokrein has 2 anticoagulant effects. name them
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activates plasminogen to plasmin; converts kininogen to bradykinin
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mechanism of heparin
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activation of antithrombin, which degrades thrombin (factor IIa)
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intrinsic and extrinsic pathways merge at...
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X to Xa
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plasminogen is activated to plasmin by ...
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tPA
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mechanism of abciximab
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inhibits GpIIb/IIIa
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mechanism of clopidigrel & ticlopidine
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inhibit ADP receptor on platelets, preventing insertion of GpIIb/IIIa into the membrane
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Glanzmann's thrombasthenia is a deficiency of...
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GpIIb/IIIa
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Bernard-Soulier syndrome is a deficiency of...
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GpIb, which binds platelets to vWF on the basement membrane
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thrombomodulin, vWF, thromboplastin, tPA, and PGI2 are synthesized by...
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endothelial cells
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hemophilia A/B
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PTT increased, otherwise normal
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vitamin K deficiency
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PT, PTT increased, PC and BT normal
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Bernard-Solier disease
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PT, PTT normal; PC decreased; BT increased
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Glanzmann's thrombasthenia
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PT, PTT normal; PC normal; BT increased
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coagulation studies in ITP and TTP
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PT, PTT normal; PC decreased; BT increased
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coagulation studies in von Willebrand's disease
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PT normal; PTT high; PC normal; BT high
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coagulation studies in DIC
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PT, PTT high; PC low; BT increased
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characterized by anti-GpIIb/IIIa antibodies
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ITP
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characterized by a deficiency of ADAMTS13 (vWF metalloprotease), leading to large vWF multimers that increase platelet aggregation
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TTP
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mix the patient's RBCs with anti-IgG antibodies and see whether RBCs agglutinate
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direct Coomb's test
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mix the patient's serum with normal RBCs and see whether RBCs agglutinate
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indirect Coomb's test
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tests for anti-RBC abs on patient's RBCs
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direct Coomb's test
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tests for anti-RBC abs in patient's serum
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indirect Coomb's test
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characterized by low serum iron, high TIBC/transferrin, low ferritin, and low % transferrin saturation
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iron deficiency anemia
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characterized by low serum Fe, low transferrin/TIBC, high ferritin, and normal % transferrin sat
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anemia of chronic disease/inflammation
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characterized by high serum Fe, low transferrin/TIBC, high ferritin, and high % transferrin saturation
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hemochromatosis
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characterized by normal serum Fe, high transferrin/TIBC, normal ferritin, and high % transferrin sat
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pregnancy or OCP's
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what is the % transferrin sat?
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serum Fe over TIBC
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characterized by high serum Fe, low transferrin/TIBC, normal ferritin, and high % tranferrin saturation
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lead poisoning
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acanthocyte (spur cell)
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liver disease, abetalipoproteinemia
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basophilic stippling due to aggregation of ribosomes (hint: TAIL)
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thal, ACD, iron deficiency, lead poisoning
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bite cell
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G6PD deficiency
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elliptocyte
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hereditary elliptocytosis
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you have iron available but cannot synthesize heme
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sideroblastic anemia, where the ring is the nucleus and the basophilic granules are Fe in mitochondria
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schistocyte or "helmet cell"
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DIC, TTP, HUS, traumatic hemolysis (eg heart valve)
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tear drop cell
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bone marrow infiltration (myelofibrosis, myelophthisis)
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target cell (hint: HALT)
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HbC, Asplenia, Liver disease, Thal
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Howell-Jolly bodies
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asplenia/hyposplenia. Basophilic nuclear remnants in RBCs
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defective in X-linked sideroblastic anemia
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ALA synthase
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inhibited by lead
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ALA dehydratase, ferrochelatase
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defective in acute intermittent porphyria
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porphobilinogen deaminase
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builds up in acute intermittent porphyria
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porphobilinogen
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defective in porphyria cutanea tarda
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uroporphyrinogen decarboxylase
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builds up in porphyria cutanea tarda
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uroporphyrinogen III
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CD30+, CD15+
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Reed-Sternberg cells
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t(11;14)
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mantle cell lymphoma
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CD5+
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poor prognosis mantle cell lymphoma
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t(12;21)
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good prognosis ALL
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S100+, CD1a+ cells in skin with Birbeck granules
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Langerhans cell histiocytosis
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mutated in chronic myeloproliferative disorders
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JAK2
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antidote for heparin
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protamine sulfate
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monitor this if you are on heparin
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PTT (intrinsic)
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monitor this if you are on warfarin
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PT (extrinsic)
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used as anticoagulants in heparin-induced thrombocytopenia
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lepirudin, bivalirudin
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inhibited by warfarin
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eposide reductase
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streprokinase, urokinase, tPA (alteplase) are examples of...
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fibrinolytics
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mechanism of tPA
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convert plasminogen to plasmin, which cleaves fibrin
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mechanism of antiplatelets cilostazol and dipyridamole
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inhibit phosphodiesterase III, increasing cAMP in platelets, inhibiting aggregation; also vasodilators
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folic acid analog that inhibits DHF reductase
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methotrexate
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pyrimidine analogue that inhibits thymidylate synthase
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5-fluorouracil
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purine analogue activated by HGPRTase
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6-mercaptopurine, 6-thioguanine
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pyrimidine analogue that inhibits DNA polymerase
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cytarabine (ara-C)
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direct DNA intercalator
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dactinomycin
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indirect DNA intercalators that generate free radicals to noncovalently intercalate and break DNA
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doxorubicin, daunorubicin
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generates free radicals leading to breaks in DNA
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bleomycin
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inhibit DNA topoisomerase II
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etoposide, teniopside
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alkylating agent that covalently cross-links DNA at guanine N7; require bioactivation by liver
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cyclophosphamide, ifosfamide
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alkylating agents that penetrate the CNS
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nitrosureas like carmustine, lomustine, semustine, streptozosin
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alkylating agent that can cause pulmonary fibrosis
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busulfan
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microtubule inhibitors that bind tubulin in M-phase and block microtubule polymerization, inhibiting formation of the mitotic spindle
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vincristine, vinblastine
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microtubule inhibitors that inhibit breakdown of the mitotic spindle, preventing anaphase
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paclitaxel and other taxols
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DNA cross-linkers that can cause nephro/ototoxicity
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cisplatin, carboplatin
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inhibits ribonucleotide reductase
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hydroxyurea
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chemo causing dilated cardiomyopathy
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doxorubicin, daunorubicin
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chemo causing pulmonary fibrosis
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bleomycin, busulfan
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chemo causing hemorrhagic cystitis preventable with mesna
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cyclophosphamide
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chemo causing peripheral neuropathy
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vincristine
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chemo causing nephro/oto preventable with amifostine and Cl- diuresis
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cisplatin, carboplatin
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toxicity of trastuzumab
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cardiotoxicity
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toxicity of imatinib
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fluid retention
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