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NPLEX I (2022) > Heme > Flashcards

Heme Flashcards

1
Q

Erythrocytes Microscopic Anatomy

A

small and biconcave
do not contain mitochondria or a nucleus
hemoglobin: four globin proteins and iron
Cl/HCO3 antiporter

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2
Q

Erythrocytes Origins

A

bone marrow

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3
Q

Erythrocytes` Maturation

A

in blood

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4
Q

Erythrocytes function

A

oxygen transport

transport of carbon dioxide

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5
Q

Erythrocytes` regulation

A

erythropoietin
low oxygen levels, increased levels of androgens
need iron, copper, zinc, folate, and B12

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6
Q

Erythrocytes synthesis

A

EPO -> bone marrow and iron is released from storage to red marrow -> stem cell -> erythroblast -> reticulocyte -> RBC

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7
Q

Erythrocytes degradation

A

120 days broken down in liver and spleen
globin -> amino acids
heme -> biliverdin -> bilirubin
iron -> bound to transferrin -> ferritin

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8
Q

Thrombocytes Microscopic Anatomy

A

anucleate, roughly disc-shaped small cytoplasmic fragments
dense granules: CASH Ca, ADP, Serotonin, Histamine
alpha granules:

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9
Q

Thrombocytes Origins

A

bone marrow

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10
Q

Thrombocytes Maturation

A

bone marrow

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11
Q

Thrombocytes function

A

platelet plug

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12
Q

Thrombocytes regulation

A

thrombopoietin from kidney

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13
Q

Thrombocytes synthesis

A

thrombopoietin from kidney -> myeloid stem cells -> megakaryoblast -> megakaryocytes -> platelets

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14
Q

Thrombocytes degradation

A

8-10 phagocytized by macrophages

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15
Q

Neutrophil Microscopic Anatomy

A

segmented nuclei
leukocyte alkaline phosphatase, collagenase, lysozyme, lactoferrin, proteinase, acid phosphatase, myeloperoxidase, beta-glucuronidase

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16
Q

Basophil Origins

A

bone marrow

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17
Q

Neutrophil Maturation

A

mature in bone marrow and release into blood 2 days after maturation

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18
Q

Neutrophil function

A

phagocytosis

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19
Q

Neutrophil regulation

A

presence of bacteria

colony -stimulating factors

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20
Q

Neutrophil synthesis

A

colony -stimulating factors bind multipotent stem cell -> myeloid stem cell -> band -> neutrophil

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21
Q

Eosinophil Microscopic Anatomy

A

2 lobed nucelli w/ red granules

antihistamine, peroxidase, major basic protein, eosinophil cationic protein, eosinophil-derived neurotoxin

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22
Q

Eosinophil Origins

A

myeloid stem cell

bone marrow

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23
Q

Eosinophil Maturation

A

bone marrow

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24
Q

Neutrophil degradation

A

circulate for 6-10 h move into tissue 2-6 days and then apoptosis by macrophages

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25
Q

Eosinophil regulation

A

T cell

colony -stimulating factors

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26
Q

Eosinophil synthesis

A

colony -stimulating factors bind to stem cell -> myeloid stem cell -> eosinophil-basophil progenitor -> myeloblast -> eosinophil

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27
Q

Eosinophil degradation

A

6 days

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28
Q

Monocyte Origins

A

myeloid stem cells

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29
Q

Monocyte Maturation

A

bone marrow

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30
Q

Monocyte function

A

phagocytize

attract other leukocytes

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31
Q

Basophil Maturation

A

blood

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32
Q

T lymphocyte function

A

attack foreign or diseased cells

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33
Q

Basophil regulation

A

IgE, IL-13, IL-4

colony -stimulating factors

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34
Q

Basophil synthesis

A

colony -stimulating factors bind to stem cell -> myeloid progenitor -> eosinophil-basophil progenitor -> myeloblast -> basophil

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35
Q

NK function

A

capable of recognizing cells that do not express “self” proteins on their plasma membrane

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36
Q

Monocyte Origins

A

myeloid stem cells

bone marrow

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37
Q

Monocyte Maturation

A

blood

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38
Q

Monocyte function

A

turns to macrophage
phagocytize
attract other leukocytes

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39
Q

Monocyte regulation

A

IL-3, stem cell factor, granulocyte-macrophage colony-stimulating factor, and macrophage colony-stimulating factor

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40
Q

Monocyte synthesis

A

colony -stimulating factors to stem cell -> myeloid -> granulocyte-monocyte progenitor -> monoblast -> promonocyte -> monocyte -> macrophage

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41
Q

Monocyte degradation

A

months

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42
Q

T lymphocyte Microscopic Anatomy

A

one large nucleus

receptors on membrane

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43
Q

T lymphocyte Origins

A

bone marrow

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44
Q

T lymphocyte function

A

CD8: kill target cells
CD4: activating other immune cells, releasing cytokines, and helping B cells to produce antibodies.

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45
Q

T lymphocyte regulation

A

infection or foreign substance

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46
Q

T lymphocyte synthesis

A

stem cell -> lymphoid progenitor -> small lymphocyte -> T lymphocyte

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47
Q

B lymphocytes Microscopic Anatomy

A

large nucleus

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48
Q

B lymphocytes Microscopic Anatomy

A

large nucleus

receptors on membrane

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49
Q

B lymphocytes function

A

produce antibodies, antigen-presenting cells, supporting other mononuclear cells

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50
Q

B lymphocytes synthesis

A

hematopoietic stem cell -> pro-B cell -> pre B cell -> immature B cell -> transitional/regulatory b cell -> naive be cell

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51
Q

NK Microscopic Anatomy

A

large, granular, perforin and granzyme

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52
Q

NK Origins

A

lymphoid stem cells

bone

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53
Q

NK function

A

capable of recognizing cells that do not express “self” proteins on their plasma membrane,

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54
Q

NK regulation

A

IL-12

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55
Q

NK synthesis

A

Hematopoietic stem cell -> lymphoid progenitor -> NK

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56
Q

Hematopoiesis

A

reg: interleukins, colony -stimulating factors, erythropoietin, thrombopoietin

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57
Q

Hematopoiesis

A

reg: interleukins, colony -stimulating factors, erythropoietin, thrombopoietin

Formation of WBC and RBC

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58
Q

Hemostasis

A
  1. nerve in surrounding area detect the injury and reflexive contraction/vasoconstriction
  2. endothelin is secreted by endothelial cells which causes smooth muscle to constrict
  3. damage endothelium releases von Willebrand’s Factor that binds to exposed collagen
  4. platelets circulating bind to the VWF via GP1B receptor
  5. platelet changes shape, releases vWF, serotonin, and Ca, ADP, thromboxane A2
  6. this attracts more platelets and activate other platelets that haven’t bound to vWF, ADP and thromboxane A2 bind to platelets and activate them
  7. platelets can bind to collagen, platelets can bind fibrinogen via GPIIB/IIIA linking two platelets together
    8.
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59
Q

Hemostasis Primary

A
  1. nerve in surrounding area detect the injury and reflexive contraction/vasoconstriction
  2. endothelin is secreted by endothelial cells which causes smooth muscle to constrict
  3. damage endothelium releases von Willebrand’s Factor that binds to exposed collagen
  4. platelets circulating bind to the VWF via GP1B receptor
  5. platelet changes shape, releases vWF, serotonin, and Ca, ADP, thromboxane A2
  6. this attracts more platelets and activate other platelets that haven’t bound to vWF, ADP and thromboxane A2 bind to platelets and activate them
  7. platelets can bind to collagen, platelets can bind fibrinogen via GPIIB/IIIA linking two platelets together
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60
Q

Secondary Hemostasis

A
  1. trauma Factor III in the smooth muscle binds active factor VII w/ Ca forming a VIIa-TF complex on membrane
  2. cleaves factor X to Xa
  3. cleaves factor 5 to 5a then binds together which activates Factor II to Factor IIa uses Ca as cofactor
  4. IIa activates platelets, factor 5, factor 8, and IX, cleaves factor I to Ia, activates XIII to XIIIa
  5. fibrin forms long protein chains holding platelets together
  6. XIIIa forms cross links bw fibrin chains
  7. XII + phosphate cleaves into XIIa
  8. XIIa cleaves factor XI into XIa + Ca cleaves IX
  9. IXa binds to VIIIa cleaving X into Xa
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61
Q

Iron Deficiency Anemia def

A

decrease in healthy RBC due to deficiency in iron

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62
Q

Iron Deficiency Anemia cause

A 
Chronic bleeding (cancer, menses, h pylori, hookworms, etc)
Malnutrition
Absorption disorders
Gastrectomy/surgery
Pregnancy, childhood
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63
Q

Iron Deficiency Anemia path

A

↓ iron -> impaired hemoglobin production -> bone marrow pumps out small and pale RBC -> ↓ O2 to tissue -> ↑ BM activation -> ↑ poikilocytosis (shape) and anisocytosis (size) -> defective mitochondrial enzymes

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64
Q

Iron Deficiency Anemia comp

A

Plummer-Vinson syndrome (triad of IDA, esophageal webs, dysphagia)

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65
Q

Iron Deficiency Anemia comp

A

Plummer-Vinson syndrome (triad of IDA, esophageal webs, dysphagia)
Glossitis
esophageal webs

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66
Q

Iron Deficiency Anemia clinical

A

Fatigue, conjunctival pallor, palpitation, pica, spoon nails (koilonychia), SOB, hair loss

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67
Q

a-Thalassemia def

A

genetic disorder decadency in alpha chains in hemoglobin

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68
Q

a-Thalassemia cause

A

a-globin gene deletions on chromo 16, decreased a-globin synthesis

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69
Q

a-Thalassemia cause

A

a-globin gene deletions on chromo 16, decreased a-globin synthesis
autosomal recessive

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70
Q

a-Thalassemia path

A 
Cis or trans deletion on chromosome  that results in absent/reduced alpha globin chains 
1 gene carrier 
2 genes mild anemia
3 genes hemoglobin H
4 genes incompatible for life
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71
Q

a-Thalassemia RF

A

Cis deletion - Asian populations
Trans deletion - African populations
areas of high incidence of malaria

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72
Q

a-Thalassemia comp

A

chronic tissue hypoxia, leg ulcers, high output heart failure, hypermetabolic state, gallstones, bone marrow hyperplasia, bone marrow widens structural malformations, iron deposition in liver, myocardium, pancreas, and kidney

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73
Q

Lead Poisoning-Related Anemia cause

A

lead exposure

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74
Q

Lead Poisoning-Related Anemia def

A

anemia due to lead poisoning

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75
Q

Lead Poisoning-Related Anemia RF

A

contaminated water, lead paint, industrial emissions (smelters, refiners, battery manufacturing, recycling) , lead-glazed ceramics

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76
Q

Lead Poisoning-Related Anemia comp

A

developmental delays, learning difficulties, chronic kidney disease, HTN, low libido, infertility, SIADH,

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77
Q

Lead Poisoning-Related Anemia clinical

A

fatigue, dyspnea, activity intolerance, abdominal pain, headache, difficulty concentrating, muscle/joint pain, confusion, ataxia

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78
Q

Beta Thalassemia def

A

deficiency or absence in the beta chains

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79
Q

Lead Poisoning-Related Anemia clinical

A

fatigue, dyspnea, activity intolerance, abdominal pain, headache, difficulty concentrating, muscle/joint pain, confusion, ataxia

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80
Q

Beta Thalassemia cause

A

mutation in beta globins

1: carrier
2: mild anemia

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81
Q

Beta Thalassemia path

A

genetic mutation -> absent/lack beta chains -> unstable hemoglobin

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82
Q

Beta Thalassemia comp

A

chronic tissue hypoxia, leg ulcers, high output heart failure, hypermetabolic state, gallstones, bone marrow hyperplasia, bone marrow widens structural malformations, iron deposition in liver, myocardium, pancreas, and kidney

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83
Q

Beta Thalassemia RF

A

FH, Mediterranean, middle eastern, southeast Asian, African genetic descent

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84
Q

Autoimmune Hemolytic Anemia def

A

low levels of RBC due to destruction of them

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85
Q

Autoimmune Hemolytic Anemia cause

A

autoantibodies against antigens on RBCs surface at or below body temp

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86
Q

Autoimmune Hemolytic Anemia path

A

Warm: IgG to Rh on RBC at normal body temp, antibody fixes complement + binds to RBC membrane -> antibody-coated RBCs destroyed extravascular by macrophages in spleen, liver

Cold: IgM, I, i, P
antibodies activate direct complement system attack, intravascular, complement-mediated

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87
Q

Autoimmune Hemolytic Anemia RF

A

immune deficiencies, malignancies, certain drugs, measles, varicella, mycoplasma, H. influenza, lymphoproliferative disorders, autoimmune disorders,

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88
Q

Autoimmune Hemolytic Anemia RF

A

immune deficiencies, malignancies, certain drugs, measles, varicella, mycoplasma, H. influenza, lymphoproliferative disorders, autoimmune disorders, exposure to cold

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89
Q

Autoimmune Hemolytic Anemia comp

A

venous thromboembolism, cholelithiasis, renal insufficiency, cardiac comp (older)

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90
Q

Autoimmune Hemolytic Anemia clinical

A

pallor, fatigue, activity intolerance, bounding pulses, tachycardia, pulmonary congestion,

cold: hemoglobinuria, jaundice, pain in legs and back, anemia, acrocyanosis, Raynaud’s, anemia after infx

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91
Q

Autoimmune Hemolytic Anemia clinical

A

pallor, fatigue, activity intolerance, bounding pulses, tachycardia, pulmonary congestion,

cold: hemoglobinuria, jaundice, pain in legs and back, anemia, acrocyanosis, Raynaud’s, anemia after infx

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92
Q

Glucose-6-Phosphate Dehydrogenase Deficiency cause

A

inherited, X-linked of G6PD

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93
Q

Glucose-6-Phosphate Dehydrogenase Deficiency path

A

inadequate G6PD, GSH -> oxidative stress -> build-up of free radicals, peroxides -> precipitation of hemoglobin -> disruption of cell membrane -> ↑ cellular rigidity -> extravascular hemolysis, accelerated removal of damaged RBCs by reticuloendothelial system in spleen; intravascular hemolysis may also occur

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94
Q

Glucose-6-Phosphate Dehydrogenase Deficiency path

A

inadequate G6PD, GSH -> oxidative stress -> build-up of free radicals, peroxides -> precipitation of hemoglobin -> disruption of cell membrane -> ↑ cellular rigidity -> extravascular hemolysis, accelerated removal of damaged RBCs by reticuloendothelial system in spleen; intravascular hemolysis may also occur

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95
Q

Glucose-6-Phosphate Dehydrogenase Deficiency comp

A

favism

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96
Q

Glucose-6-Phosphate Dehydrogenase Deficiency clinical

A

pallor, jaundice, dark urine, abdominal/back pain, renal insufficiency,

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97
Q

Hemolytic Disease of the Newborn def

A

anemia of the newborn from destruction of RBCs

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98
Q

Hemolytic Disease of the Newborn cause

A

Rh, A, B, AB, O blood groups

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99
Q

Hemolytic Disease of the Newborn path

A

fetomaternal hemorrhage exposes maternal circulation to antigens present on fetal RBCs -> maternal sensitization -> formation of maternal IgG antibodies against fetal RBCs -> IgG antibodies small enough to cross placenta -> antibody attachment to fetal cells -> agglutination -> microcirculatory impairment -> hemolysis, destruction of RBCs by macrophages in reticuloendothelial system

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100
Q

Hemolytic Disease of the Newborn RF

A

blood group incompatibility, fetomaternal hemorrhage

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101
Q

Hemolytic Disease of the Newborn comp

A

anemia, hyperbilirubinemia, kernicterus, growth restriction, hydrops fetalis, erythroblastosis fetalis

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102
Q

Hemolytic Disease of the Newborn clinical

A

ABO: hyperbilirubinemia, anemia
Rh: hyperbilirubinemia, kernicterus, pallor, lethargy, tachycardia, tachypnea, subcutaneous edema, pleural/pericardial effusion, ascites, shock

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103
Q

Hereditary Spherocytosis def

A

RBC membrane defect

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104
Q

Hereditary Spherocytosis cause

A

autosomal dominant

autosomal recessive

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105
Q

Hereditary Spherocytosis path

A

mutation of genes encoding for proteins that secure RBC membrane skeleton to plasma membrane -> membrane destabilization -> rigidity, resistance to deformability -> hemolysis

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106
Q

Hereditary Spherocytosis comp

A

transient aplastic crisis caused by parvovirus B19
megaloblastic anemia
neonatal icterus, non-immune hydrops fetalis

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107
Q

Hereditary Spherocytosis clinical

A

Mild: anemia, splenomegaly, jaundice, modest reticulocytosis, normal hemoglobin, adolescents/adults

Moderate: anemia, reticulocytosis, hyperbilirubinemia, infants/children

Severe: anemia, hyperbilirubinemia, splenomegaly,

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108
Q

Hereditary Spherocytosis RF

A

northern European descent

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109
Q

Paroxysmal Nocturnal Hemoglobinuria def

A

hematologic stem cell disorder

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110
Q

Paroxysmal Nocturnal Hemoglobinuria cause

A

X-linked, PIGA mutation,

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111
Q

Paroxysmal Nocturnal Hemoglobinuria path

A

PIGA gene mutated -> ↓ glycosylphosphatidylinositol -> ↑ susceptibility to complement activity -> complement-mediated intravascular hemolysis

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112
Q

Paroxysmal Nocturnal Hemoglobinuria path

A

PIGA gene mutated -> ↓ glycosylphosphatidylinositol -> ↑ susceptibility to complement activity -> complement-mediated intravascular hemolysis

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113
Q

Paroxysmal Nocturnal Hemoglobinuria comp

A

smooth muscle dystonia, vasospasm, abdominal pain, esophageal spasm, erectile dysfunction, venous or arterial thrombosis, chronic kidney disease, BM failure, neisserial infx

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114
Q

Paroxysmal Nocturnal Hemoglobinuria clinical

A

dark urine, hemolysis, pallor, fatigue, exertional dyspnea

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115
Q

Pyruvate Kinase Deficiency def

A

deficient pyruvate kinase

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116
Q

Pyruvate Kinase Deficiency cause

A

autosom

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117
Q

Pyruvate Kinase Deficiency cause

A

autosomal recessive mutation of pyruvate kinase-LR

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118
Q

Pyruvate Kinase Deficiency path

A

pyruvate kinase deficiency-related block in glycolysis -> accumulation of 2,3-bisophospglucerate -> shifts oxyhemoglobin dissociation curve to right -> improved oxygen delivery to tissues -> better tolerance of hemolytic anemia -> ATP deficiency, apoptosis of erythroid progenitors in spleen

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119
Q

Pyruvate Kinase Deficiency RF

A

white people of Northern European descent, Asian people of Chinese descent, genetically-isolated communities of Swiss/German descent

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120
Q

Pyruvate Kinase Deficiency comp

A

pigmented gallstone formation, iron overload-associated organ damage, megaloblastic anemia related to folate deficiency, neonatal icterus/non-immune hydrops fetalis, transient aplastic crisis induced by parvovirus B19

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121
Q

Pyruvate Kinase Deficiency clinical

A

pallor, SOB, activity intolerance, jaundice, splenomegaly,

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122
Q

Sickle cell anemia def

A

hemolytic anemia caused by mutation of beta globin

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123
Q

Sickle cell anemia cause

A

mutation of beta globin
HbSS: homozygous for HbS
HbSC: heterozygous for HbS + abnormal hemoglobin C
HbSA: heterozygous HbS + hemoglobin A
HbS beta thalassemia: heterozygous HbS + 1 beta thalassemia gene

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124
Q

Sickle cell anemia path

A

point mutation of beta globin gene -> produces hemoglobin S -> RBC polymerize, deform into sickle/crescent-shaped forms when deoxygenated

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125
Q

Sickle cell anemia RF

A

areas where there are mosquitoes that carry malaria

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126
Q

Sickle cell anemia comp

A

ischemia/infraction, stroke, transient ischemic attack, seizures, MI, dysrhythmias, cardiomyopathy, HF, thromboembolism, leg ulcers, sudden death, acute chest syndrome, pulmonary HTN, priapism, pregnancy complications, osteoporosis, proliferative retinopathy, retinal detachment, multiorgan failure

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127
Q

Sickle cell anemia clinical

A

fatigue, activity intolerance, exertional dyspnea, hypersplenism, pain, vaso-occlusion, dactylitis, increased risk of infx,

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128
Q

Hemolytic normocytic anemia

A

hemolytic disease of newborn, G6PD, autoimmune hemolytic anemia, hereditary spherocytosis, paroxysmal nocturnal hemoglobinuria, pyruvate kinase deficiency, sickle cell anemia,

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129
Q

Macrocytic anemia

A

megaloblastic anemia, sideroblastic anemia,

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130
Q

Microcytic Hypochromic anemia

A

iron deficiency, lead poisoning, thalassemia, sideroblastic anemia, late chronic disease anemia

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131
Q

Iron deficiency lab findings

A 
low serum iron 
low ferritin 
high iron binding capacity
hypochromic
microcytic
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132
Q

Lead poisoning lab findings

A 
low serum iron 
low ferritin 
high iron binding capacity
hypochromic
microcytic
133
Q

Thalassemia lab findings

A 
normal or high iron 
normal or high ferritin 
normal iron binding capacity 
hypochromic 
microcytic
134
Q

normocytic normochromic anemia

A

anemia of chronic disease, aplastic anemia, Autoimmune Hemolytic Anemia, paroxysmal nocturnal hemoglobinuria, fanconi anemia

135
Q

Anemia of chronic disease def

A

deficient RBC production due to chronic disease

136
Q

Anemia of chronic disease cause

A

infx, cancer, diabetes, autoimmune,

137
Q

Anemia of chronic disease path

A

systemic inflammation -> ↑ circulation cytokines, IL-1, IL-6, TNF alpha, IFN beta, IFN gamma -> ↑ hepcidin secretion by liver -> ↓ iron absorption from GI tract, ↓ iron sequestration in reticuloendothelial system -> ↓ iron available for erythropoiesis -> ↓ secretion erythropoietin -> ↓ erythrocyte lifespan

138
Q

Anemia of chronic disease labs

A

normochromic normocytic
low serum iron
high ferritin

139
Q

Anemia of chronic disease labs

A

normochromic normocytic
low serum iron
high ferritin
low serum transferrin saturation

140
Q

Aplastic anemia def

A

bone marrow hypoplasia/aplasia

141
Q

Aplastic anemia cause

A

Fanconi anemia, Shwachman-Diamond syndrome, SLE, graft-versus-host disease, paroxysmal nocturnal hemoglobinuria, chemotherapy, carbamazepine, phenytoin, indomethacin, sulfonamides, Epstein-Barr, HIV, hepatitis, herpes, solvents, benzene, pesticides, radiation, idiopathic

142
Q

Aplastic anemia comp

A

impaired blood immunity, hemostasis, oxygen-carrying capacities

143
Q

Aplastic anemia path

A

bone marrow hypoplasia/aplasia, hematopoietic cell loss -> ↓ production of cell lineages -> peripheral pancytopenia

144
Q

Aplastic anemia clinical

A

shorter lifespan, ↑ infx, neutropenia-related sepsis, gingival nares, ecchymosis, petechiae, heavy menstrual flow, occult blood in stool, intracranial hemorrhage, pallor, fatigue, dyspnea, activity intolerance, cardiorespiratory compromise

145
Q

Aplastic anemia clinical

A

shorter lifespan, ↑ infx, neutropenia-related sepsis, gingival nares, ecchymosis, petechiae, heavy menstrual flow, occult blood in stool, intracranial hemorrhage, pallor, fatigue, dyspnea, activity intolerance, cardiorespiratory compromise

146
Q

Diamond-Black Anemia def

A

inherited bone marrow failure syndrome

147
Q

Diamond-Black Anemia cause

A

autosomal dominant

148
Q

Diamond-Black Anemia path

A

genetic mutation -> ribosomopathy -> impaired hematopoiesis -> RBC aplasia -> macrocytic normochromic anemia

149
Q

Diamond-Black Anemia RF

A

FH

150
Q

Diamond-Black Anemia comp

A

myelogenous leukemia, myelodysplastic syndrome, solid tumors

151
Q

Diamond-Black Anemia clinical

A

anemia at birth, pallor, tachycardia, apnea, lethargy, low birth weight, low-set ears, micrognathia, high-arched/cleft palate, broad nasal bridge, short neck, congenital glaucoma, cataracts, strabismus, duplex/bifid, flat thenar eminence, horseshoe or absent kidney, ventricular/atrial septal defect, coarctation of aorta,

152
Q

Diamond-Black Anemia clinical

A

anemia at birth, pallor, tachycardia, apnea, lethargy, low birth weight, low-set ears, micrognathia, high-arched/cleft palate, broad nasal bridge, short neck, congenital glaucoma, cataracts, strabismus, duplex/bifid, flat thenar eminence, horseshoe or absent kidney, ventricular/atrial septal defect, coarctation of aorta,

153
Q

Fanconi anemia def

A

inherited bone marrow failure syndrome

154
Q

Fanconi anemia cause

A

mutation of several genes responsible for DNA repair

VACTERL-H

155
Q

Fanconi anemia path

A

impaired cellular repair of DNA cross-links -> impaired regulation of cell cycle, genomic instability -> hematopoietic stem cell loss -> macrocytic-normochromic anemia -> bone marrow aplasia -> pancytopenia

156
Q

Fanconi anemia comp

A

blood and solid tumor malignancies, life-threatening infx, bleeding tendencies, hypothalamic-pituitary axis disruption, congenital anomalies

157
Q

Fanconi anemia clinical

A

increased bruising, bleeding, frequent infx, pallor, SOB, exercise intolerance, microcephaly, congenital heart disease, imperforate anus, conductive deafness, hypogenitalia, café-au-lait spots

158
Q

Fanconi anemia labs

A

macrocytic normochromic anemia, pancytopenia

159
Q

Megaloblastic anemia def

A

anemia characterized by formation of large RBCs

160
Q

Megaloblastic anemia cause

A

cobalamin and/or folate deficiency due to diet, malabsorption, medications, surgery, pancreatic insufficiency, alcoholism

161
Q

Megaloblastic anemia path

A

impaired DNA synthesis during erythropoiesis -> uncoordinated maturation of cytoplasm and nuclei in erythroblasts -> abnormally large RBCs + deflective cells w/ fragile membranes -> RBC die prematurely -> anemia

162
Q

Megaloblastic anemia path

A

impaired DNA synthesis during erythropoiesis -> uncoordinated maturation of cytoplasm and nuclei in erythroblasts -> abnormally large RBCs + deflective cells w/ fragile membranes -> RBC die prematurely -> anemia

163
Q

Megaloblastic anemia RF

A

alcohol use, old age, strict diets,

164
Q

Megaloblastic anemia clinical

A

fatigue, activity intolerance, pallor, tachycardia, bounding pulse, jaundice, splenomegaly, glossitis

165
Q

Folate deficiency def

A

lack of folate

166
Q

Folate deficiency cause

A

malnutrition, malabsorption, drugs (methotrexate, trimethoprim, phenytoin, pregnancy

167
Q

Folate deficiency path

A

impaired DNA synthesis during erythropoiesis -> uncoordinated maturation of cytoplasm and nuclei in erythroblasts -> abnormally large RBCs + deflective cells w/ fragile membranes -> RBC die prematurely -> anemia

168
Q

Folate deficiency RF

A

alcohol use, strict diets

169
Q

Folate deficiency clinical

A

fatigue, activity intolerance, pallor, tachycardia, bounding pulse, jaundice, splenomegaly,

170
Q

B12 deficiency def

A

lack of B12 in body

171
Q

B12 deficiency cause

A

diet, malabsorption, intrinsic factor deficiency, gastrectomy, pancreatic insufficiency, biguanides, H2 receptor blockers, PPIs, neomycin, Diphyllobothrium latum

172
Q

B12 deficiency path

A

impaired DNA synthesis during erythropoiesis -> uncoordinated maturation of cytoplasm and nuclei in erythroblasts -> abnormally large RBCs + deflective cells w/ fragile membranes -> RBC die prematurely -> anemia

173
Q

B12 deficiency RF

A

diet, autoimmune, stomach

174
Q

B12 deficiency comp

A

infertility, stomach cancer,, neural tube defect

B12 SINs

175
Q

B12 deficiency clinical

A

reversible dementia, numbness, tingling, weakness

176
Q

Folate deficiency comp

A

infertility, CVD, cancer, neural tube defects

177
Q

What are the macrocytic hyperchromic anemias?

A

megaloblastic anemia, Vit B12, folate,

178
Q

Which anemias is macrocytic normochromic?

A

Fanconi anemia

Diamond-Black Anemia

179
Q

Which anemia is microcytic or macrocytic hypochromic?

A

sideroblastic anemia

180
Q

sideroblastic anemia def

A

anemia caused by altered mitochondrial function and defects in heme synthesis w/in erythroid cells

181
Q

sideroblastic anemia cause

A

X-linked/autosomal recessive/mitochondrial inheritance, myelodysplastic syndromes, myeloproliferative neoplasms, excessive alcohol, isoniazid, chloramphenicol, copper deficiency, zinc overload

182
Q

sideroblastic anemia path

A

impaired erythropoiesis, hemoglobin synthesis -> reduced iron in RBCs + defective RBCs undergo apoptosis w/in bone marrow + fewer functional RBCs in circulation -> anemia

183
Q

sideroblastic anemia RF

A

genetics, alcohol, diet

184
Q

sideroblastic anemia comp

A

iron overload, hemochromatosis, erythroid hyperplasia of bone marrow, increased risk of infx, acute leukemia, infx fatal

185
Q

sideroblastic anemia clinical

A

fatigue, dyspnea, palpitations, pallor, mild jaundice, hepatosplenomegaly, cardiac arrhythmias, HF

186
Q

Which anemia is Microcytic hyperchromic

A

hereditary spherocytosis

187
Q

Polycythemia Vera def

A

increased blood cells levels due to overproduction by bone marrow

188
Q

Polycythemia Vera cause

A

JAK2V617F mutation

189
Q

Polycythemia Vera path

A

hematopoietic stem cell -> ↑ RBCs, platelets, basophils, eosinophils -> ↑ blood viscosity, ↑ total blood volume -> may evolve into spent phase

190
Q

Polycythemia Vera RF

A

age, genetics

191
Q

Polycythemia Vera comp

A

HTN, Budd-Chiari syndrome, DVT, arterial thrombosis, MI, gout, AML

192
Q

Polycythemia Vera clinical

A

headache, fatigue, dizziness, dyspnea, plethora, cyanosis, pruritus, gastric ulcers, DVT, MI, portal vein thrombosis, hyperemic and inflamed extremities, bleeding gums, epistaxis, ecchymoses, GI bleed, hepatosplenomegaly, HTN

193
Q

Polycythemia secondary def

A

overproduction of RBCS

194
Q

Polycythemia secondary cause

A

Chronic lung disease, CHF, Carbon monoxide poisoning, obstructive sleep apnea, renal artery stenosis, tumors, drugs, adrenal cortical hypersecretion

195
Q

Polycythemia secondary path

A

↓ oxygen to tissue -> ↑ EPO -> ↑ RBCs

196
Q

Polycythemia secondary RF

A

genetics, meds, smoking,

197
Q

Polycythemia secondary comp

A

stroke, venous thromboembolism, pulmonary HTN, Increased whole blood viscosity,

198
Q

Polycythemia secondary clinical

A

fatigue, headache, and dizziness

199
Q

Disseminated Intravascular Coagulation def

A

process of hemostasis gets out of control leading to overproduction of clots,

200
Q

Disseminated Intravascular Coagulation cause

A 
DIC TEAR 
Delivery TEAR: obstetric 
Infection
Cancer: prostate, pancreas, lung, stomach  
Toxemia of pregnancy 
Emboli 
Abruptio placentae
Retain fetus products

preeclampsia, obstetric hemorrhage, retained dead fetus, critical illness, mucin-secreting adenocarcinoma, acute promyelocytic leukemia, infx/sepsis (gram - bacteria), massive tissue injury, intravascular hemolysis, shock, snakebites

201
Q

Disseminated Intravascular Coagulation path

A

release of procoagulants, tissue factors, bacterial components, enzymes/major endothelial injury -> excessive activation of coagulation cascade -> thrombosis of small/medium blood vessels -> activation of fibrinolysis to resolve clots -> fibrin degradation products released into circulation -> interfere w/ platelet aggregation, clot formation

202
Q

Disseminated Intravascular Coagulation RF

A

sepsis, cancer, blood transfusion reaction, pancreatitis, liver disease, surgery, anesthesia,

203
Q

Disseminated Intravascular Coagulation comp

A

thromboembolism, tissue hypoxia, infraction, hypoxia of kidney, liver, lung, brain

204
Q

Hemophilia A def

A

a condition where clots hemostasis is impaired leading to increased bleeding

205
Q

Hemophilia A cause

A

X-linked recessive mutation F8 gene

206
Q

Hemophilia A path

A

quantitative/qualitative deficiency of factor VII -> insufficient activation of the intrinsic pathway -> defect in common coagulation pathway -> increased tendency for bleeding

207
Q

Hemophilia A RF

A

male

208
Q

Hemophilia A comp

A

intracerebral hemorrhage, stroke

209
Q

Hemophilia A clinical

A

asymptomatic
easy bruising, prolonged bleeding, hematomas, muscle hematomas, hemophilic pseudotumor, GI bleeding, hematuria, severe epistaxis, joint irregularity and disability,

210
Q

Hemophilia B def

A

deficiency in clotting factors

211
Q

Hemophilia B cause

A

mutation of F9 on X chromosome

212
Q

Hemophilia B path

A

qualitative/quantitative deficiency of coagulation factor IX -> insufficient activation of intrinsic coagulation pathway -> impaired hemostasis

213
Q

Hemophilia B comp

A

intracerebral hemorrhage, stroke

214
Q

Hemophilia B RF

A

genetics, male

215
Q

Von Willebrand Disease def

A

defective platelet function w/ normal platelet count

216
Q

Von Willebrand Disease cause

A

autosomal dominant/recessive

217
Q

Von Willebrand Disease path

A

quantitative/qualitative deficiency of vWF -> impaired platelet aggregation, adhesion, dysfunction of factor VII -> deficiency in coagulation cascade -> bleeding tendency

218
Q

Von Willebrand Disease RF

A

genetics

219
Q

Von Willebrand Disease comp

A

severe bleeding, pregnancy probs

220
Q

Von Willebrand Disease clinical

A

asymptomatic
surgery/trauma bring on
spontaneous epistaxis, easy bruising, excessive bleeding from wounds, bleeding gums, menorrhagia, GI bleeding, internal/joint bleeding

221
Q

Immune Thrombocytopenic Purpura def

A

autoimmune condition where body makes antibodies to thrombocytes/platelets

222
Q

Immune Thrombocytopenic Purpura cause

A

Acute: children after viral infx
Chronic: females of reproductive age, no underlying trigger, or by hepatitis C, HIV, lupus

223
Q

Immune Thrombocytopenic Purpura path

A

IgG antibodies from the spleen -> bind to GPIIb/IIIa on platelet -> target for destruction of platelets in spleen

224
Q

Immune Thrombocytopenic Purpura clinical

A

asymptomatic

purpura (red/purple spots small)

225
Q

Immune Thrombocytopenic Purpura RF

A

women, no vaccination,

226
Q

Immune Thrombocytopenic Purpura comp

A

hemorrhage

227
Q

Immune Thrombocytopenic Purpura clinical

A

asymptomatic
purpura (red/purple spots small)
epistaxis

228
Q

Vitamin K Deficiency def

A

lack of Vit K

229
Q

Vitamin K Deficiency cause

A

exclusive breastfeeding, medication, lack of Vit K1 prophylaxis at birth, malabsorption, low intake, diseases of SM intestine, liver, gallbladder, pancreas

230
Q

Vitamin K Deficiency path

A

↓ phylloquinone ( vit K) -> ↓ bile salts make fat soluble vitamin soluble -> ↓ incorporation into GI micelles -> ↓ absorbed by small intestine -> ↓ integrated into chylomicrons -> ↓ transported to portal circulation -> ↓ liver use to synthesize coagulation factors, other essential proteins

231
Q

Vitamin K Deficiency RF

A

infants: no K1 prophylaxis, immature liver, low K stores, sterile gut, maternal ingestion of coumarin-like anticoagulants/some anticonvulsants/antibiotics,
adults: prolonged diarrhea, antibiotics, low intake, TPN administration

232
Q

Vitamin K Deficiency comp

A

intracranial hemorrhage, impaired bone mineralization, vascular calcium deposits

233
Q

Vitamin K Deficiency clinical

A

low bone density signs, gingival bleeding, epistaxis, easy bruising, hematuria, melena, umbilical stump/circumcision site bleeding, vomiting, seizures

234
Q

Acute Lymphoblastic Leukemia (ALL) def

A

uncontrolled proliferation of partially developed white blood cells/lymphoblasts, cancer

235
Q

Acute Lymphoblastic Leukemia (ALL) cause

A

B cell: translocation (12,21) and (9,22) Philadelphia chromosome
T cell: NOTCH1 mutation
abnormal chromosome number

236
Q

Acute Lymphoblastic Leukemia (ALL) path

A

mutations -> loss ability to differentiate into mature blood cells -> stuck in blast cells -> don’t function effectively and divide uncontrollably -> other cells get crowded out -> leading to anemia, thrombocytopenia, and leukopenia -> blast cells spill into blood travel to thymus, lymph nodes, liver, spleen to enlarge

237
Q

Acute Lymphoblastic Leukemia (ALL) RF

A

young age
down syndrome
radiation exposure
alkylating chemotherapy

238
Q

Acute Lymphoblastic Leukemia (ALL) comp

A

intracranial hemorrhage

239
Q

Acute Lymphoblastic Leukemia (ALL) clinical

A

Fever, fatigue, SOB, pallor, bruising, petechiae, epistaxis, Bone pain, Hepatosplenomegaly, lymphadenopathy, easy bleeding, inc infx, thymus enlargement

240
Q

Acute Myeloblastic Leukemia (AML)

def

A

uncontrolled proliferation of myeloblasts, cancer

241
Q

Acute Myeloblastic Leukemia (AML) cause

A

chromosomal translocations (15, 17), myelodysplastic syndrome

242
Q

Acute Myeloblastic Leukemia (AML) path

A

mutations -> loss ability to differentiate into mature blood cells -> stuck in blast cells -> don’t function effectively and divide uncontrollably -> other cells get crowded out -> leading to anemia, thrombocytopenia, and leukopenia -> blast cells spill into blood travel to thymus, lymph nodes, liver, spleen to enlarge

243
Q

Acute Myeloblastic Leukemia (AML) RF

A

down syndrome
radiation
alkylating chemotherapy

244
Q

Acute Myeloblastic Leukemia (AML) comp

A

DIC

245
Q

Acute Myeloblastic Leukemia (AML) clinical

A

easy bleeding, inc infx, Fever, fatigue, SOB, pallor, bruising, petechiae, epistaxis, Bone pain, swelling of gums

246
Q

Chronic Myelogenous Leukemia (CML) def

A

cancer rapid proliferation of mature granulocytes/precursors

247
Q

Chronic Myelogenous Leukemia cause

A

Philadelphia chromosome t(9,22) BCR-ABL gene
trisomy of chromosome
doubling of Philadelphia chromosome

248
Q

Chronic Myelogenous Leukemia path

A

mutation -> tyrosine kinase is one -> rapid division of myeloid cells -> spill into blood -> liver spleen cause to swell

249
Q

Chronic Myelogenous Leukemia RF

A

adult age, radiation, benzene

250
Q

Chronic Myelogenous Leukemia comp

A

Recurrent infections, bleeding

251
Q

Chronic Myelogenous Leukemia clinical

A

chronic: asymptomatic, fatigue, weight loss, fever,

accelerated phase: pallor, SOB, splenomegaly, hepatomegaly, lymphadenopathy, recurrent infx, bleeding, petechiae, ecchymoses,

blast crisis: bone pain, fever, anemia, significant splenomegaly, inc bleeding, basophilia

252
Q

Chronic Lymphocytic Leukemia def

A

cancer, proliferation of mature, functionally abnormal B lymphocytes in bone marrow and don’t die

253
Q

Chronic Lymphocytic Leukemia path

A

mutation -> interfere w/ B cell receptors -> activate tyrosine kinase (bruton’s tyrosine kinase and other) -> prevent maturation and slow death - move to lymph nodes

254
Q

Chronic Lymphocytic Leukemia clinical

A

fatigue, SOB, pallor, bruising, petechiae, epistaxis, fever, pneumonia, sepsis, lymphadenopathy

255
Q

Burkitt’s Lymphoma def

A

B lymphocyte tumor

256
Q

Burkitt’s Lymphoma cause

A

chromosomal translocation t(8,14)

257
Q

Burkitt’s Lymphoma path

A

translocation -> Myc gene moved adjacent to IgH promoter sequence -> upregulation of Myc gene -> Myc gene simulates cell growth, metabolism -> increased cell division

258
Q

Burkitt’s Lymphoma RF

A

EBV infection, Africa

259
Q

Burkitt’s Lymphoma clinical

A

“Starry sky” appearance

260
Q

Hodgkin Lymphoma def

A

cancer arising from B-cells

261
Q

Hodgkin Lymphoma cause

A

nodular sclerosis

262
Q

Burkitt’s Lymphoma clinical

A

“Starry sky” appearance (b-cells w/ no cytoplasm and tingible-body macrophages w/ dead neoplastic cells)
extranodal involvement at jaw (Africa) or ileocecal junction

263
Q

Subtypes of Classical Hodgkin Lymphoma

A

nodular sclerosis: most common, nodules surrounded by collagen, lacunar cell

mixed cellularity: b lymphocytes, plasma cells, eosinophils, lymphocytes, neutrophils, histocytes, immunocompromised

lymphocyte-rich: lymphocytes surrounding Reed-Sternberg cells, best prognosis

lymphocyte-depleted: lack of normal lymphocytes, abundance of Reed-Sternberg cells, immunocompromised

264
Q

Hodgkin Lymphoma cause

A

mutation in DNA

265
Q

Hodgkin Lymphoma path

A

mutation -> cell growth and division

266
Q

Hodgkin Lymphoma RF

A

20, 60s< EBV

267
Q

Hodgkin Lymphoma comp

A

second cancer

268
Q

Hodgkin Lymphoma clinical

A

spread to nearby lymph nodes in a contiguous manner
swollen lymph nodes that are painless, rubbery, non-erythematous, nontender including cervical
supraclavicular and axillary
fever, weight loss, night sweats
Reed-Sternberg cells (binucleated neoplastic B cells)

269
Q

Non-Hodgkin Lymphoma def

A

cancer of the B or T cells

270
Q

Non-Hodgkin Lymphoma cause

A

chromosomal translocation (14, 18) BCL2 gene, BCL-6 and BCL-2 mutation, Human T-Lymphotropic Virus, chromosomal translocation (11, 14) BCL1 gene

271
Q

Non-Hodgkin Lymphoma path

A

mutations -> uncontrolled cell division

272
Q

Non-Hodgkin Lymphoma RF

A

old age, smoking, FH,

273
Q

Non-Hodgkin Lymphoma comp

A

metastases, respiratory problems

274
Q

Non-Hodgkin Lymphoma clinical

A

swollen lymph nodes that are painless, rubbery, non-erythematous, nontender in bone marrow, GI tract, spinal cord, fever, weight loss night sweats

275
Q

Subtypes of Classical Hodgkin Lymphoma

A

nodular sclerosis: most common, nodules surrounded by collagen, lacunar cell, young age,

mixed cellularity: b lymphocytes, plasma cells, eosinophils, lymphocytes, neutrophils, histocytes, immunocompromised

lymphocyte-rich: lymphocytes surrounding Reed-Sternberg cells, best prognosis

lymphocyte-depleted: lack of normal lymphocytes, abundance of Reed-Sternberg cells, immunocompromised, rare, 30-37

276
Q

Nodular Lymphocyte Predominant Hodgkin Lymphoma

A

abnormal b cells express CD20 & CD 45 and don’t express CD15 & CD30
popcorn cells, large number of lymphocytes cluster around popcorn cells forming nodules

277
Q

Follicular Lymphoma cause

A

chromosomal translocation (14, 18) BCL2 gene

278
Q

Mantel cell Lymphoma RF

A

male

279
Q

Marginal Zone Lymphoma RF

A

older people, H. pylori, hepatitis C

280
Q

Follicular Lymphoma clinical

A

waxing/waning lymphadenopathy

281
Q

Diffuse Large B-cell lymphoma def

A

b cell lymphoma, aggressive growth of b cells, most common in adults

282
Q

Diffuse Large B-cell lymphoma cause

A

BCL-6 and BCL-2 mutation

283
Q

Mantel cell Lymphoma cause

A

chromosomal translocation (11, 14) BCL1 gene

284
Q

Adult T-cell Lymphoma def

A

proliferation of T cell

285
Q

Adult T-cell Lymphoma cause

A

Human T-Lymphotropic Virus

286
Q

Adult T-cell Lymphoma path

A

Human T-Lymphotropic Virus RNA -> DNA -> incorporates into T cell DNA -> cancer

287
Q

Adult T-cell Lymphoma clinical

A

severe hypercalcemia, bone lesions

288
Q

Mycosis Fungoides clinical

A

patch or plaque like lesions that look like fungal infection, Pautrier micro abscesses in the epidermis

289
Q

Lymphoplasmacytic Lymphoma

A

bone marrow, lymph nodes, spleen, Waldenstrom macroglobulinemia

290
Q

Adult T-cell Lymphoma cause

A

Human T-Lymphotropic Virus

291
Q

Adult T-cell Lymphoma clinical

A

severe hypercalcemia, bone lesions

292
Q

Mycosis Fungoides clinical

A

patch or plaque like lesions that look like fungal infection, Pautrier micro abscesses in the epidermis, erythroderma

293
Q

Subtypes of Non-Hodgkin Lymphoma B cell

A 
Lymphoplasmacytic Lymphoma
Marginal Zone Lymphoma
Mantel cell Lymphoma
Diffuse Large B-cell lymphoma
Follicular Lymphoma
294
Q

Subtypes of Non-Hodgkin Lymphoma T cell

A

Mycosis Fungoides

Adult T-cell Lymphoma

295
Q

Multiple Myeloma def

A

cancer of plasms cells in bone marrow

296
Q

Multiple Myeloma cause

A

t(14, 11), t( 14,6), deletion of gene TP53 tumor suppressor on chromosome 17

297
Q

Multiple Myeloma RF

A

alcohol consumption, obesity, radiation, FH

298
Q

Multiple Myeloma comp

A

amyloidosis, renal failure, death, UTIs, pneumonia, hyper-viscosity syndrome

299
Q

Multiple Myeloma path

A

bone marrow cells, myeloma cells secrete cytokines, IL6, NF-kB -> promote proliferation, survival myeloma cells -> bone resoprtion, monoclonal free light chains, inhibited hematopoiesis, and IL1beta, TNFalpha -> bone lesions, renal disease, anemia, and high calcium

300
Q

Multiple Myeloma clinical

A

CRAB (calcium, renal disease, anemia, bone lesions)
confusion, somnolence, constipation, N, thirst, fatigue, pallor, fever, infections, bleeding, bone lesions, pain, fractures, spinal cord compression, paresthesia, Bence Jones, Tamm-Horsfall proteins

301
Q

Babesiosis def

A

infection of RBC by Babesia microti, ducani, or divergems

302
Q

Babesiosis cause

A

Ixodes scapularis tick, contaminated blood transfusion

303
Q

Babesiosis def

A

infection of RBC by Babesia microti, ducani, or divergems

304
Q

Babesiosis RF

A

endemic area, May-September, blood transfusions, >50, male, asplenia, malignancy, HIV/AIDS, immunosuppressive drugs, coinfection w/ Borrelia and/or Anaplasma, premature birth

305
Q

Babesiosis comp

A

CHF, noncardiac pulmonary edema, acute respiratory distress syndrome, splenic infarct, splenic rupture, septic shock, MI, disseminated intravascular coagulation, death

306
Q

Babesiosis clinical

A

asymptomatic, fatigue, fever, chills, headache, myalgia, arthralgia, anorexia, N, cough, hypotension, poor prefusion, pulmonary edema, acute renal failure, disseminated intravascular coagulation

307
Q

Babesiosis clinical

A

asymptomatic, fatigue, fever, chills, swears, headache, myalgia, arthralgia, anorexia, N, cough, hypotension, poor prefusion, pulmonary edema, acute renal failure, disseminated intravascular coagulation
maltese cross

308
Q

Plasmodium species (Malaria) def

A

single cell parasites that get spread by mosquitoes

309
Q

Plasmodium species (Malaria) cause

A

P. falciparum, P. vivax, P. malariae, P. ovale, P. knowlesi

310
Q

Plasmodium species (Malaria) cause

A

P. falciparum (few days), P. vivax, P. malariae (few weeks), P. ovale, P. knowlesi

311
Q

Plasmodium species (Malaria) path

A

P-infected female anopheles mosquito hunts for a blood meal in evening -> Plasmodium is in a sporozoite stage in salivary gland -> mosquito’s proboscis piece skin sporozoites spill into bloodstream -> liver start asexual reproduction called schizogony -> over 1-2 weeks P. falciparum, malariae, knowlesi multiply asexually & mature to merozoites -> 1 mon-years P. ovale and vivax go dormant -> merozoites bind to duffy receptor on all different stages of RBC –> asexual reproduction 2-3 days -> trophozoite -> late trophozoite -> hemozoin/schizont -> replication -> release into RBC -> some turn into gametocytes and taken up by mosquitos -> mature and fuse into a zygote in gut -> ookinete -> oocyst rupture releasing sporozoites -> into salivary gland

312
Q

Plasmodium species (Malaria) clinical

A

paroxysm of fevers P. falciparum (variable), P. vivax (48 h), P. malariae (72), P. ovale (48), P. knowlesi (24 h)

313
Q

Plasmodium species (Malaria) comp

A

death, organ failure, cerebral malaria (altered mental status, seizure, coma), diarrhea, jaundice, vomiting, liver failure

314
Q

Plasmodium species (Malaria) clinical

A

paroxysm of fevers P. falciparum (variable, worst infx), P. vivax (48 h), P. malariae (72), P. ovale (48), P. knowlesi (24 h)
fatigue, headaches, jaundice, splenomegaly,

Susan just headed for fiji

315
Q

Schistosomiasis def

A

parasitic flatworms that cause damage in the mesenteries of the bladder

316
Q

Schistosomiasis cause

A

Schistosoma haematobium, S. japonicum, and S. mansoni

317
Q

Schistosomiasis path

A

Schistosoma eggs are eleminated in feces or urine into water -> eggs hatch and release miracidia -> miracidia penetrate snail tissue -> sporocyst develop in snail -> free-swimming cercariae released from snail into water -> cercariea penetrates skin -> cerciarea loses tails during penetration and becomes shcistocomulae -> migration to liver through circulation -> adult form -> migration to mesenteric venules/vesical venous plex -> egg deposit -> inflammation -> fibrosis

318
Q

Schistosomiasis RF

A

male, rural areas, contact w/ fresh water bodies in endemic areas

319
Q

Schistosomiasis comp

A

bacteremia, infertility, intestinal obstruction, nephrotic syndrome, renal failure, cardiomegaly, acute myelopathy

320
Q

Schistosomiasis clinical

A

Acute: pruritic papular/urticarial rash of legs/feet, fever, urticaria, chills, arthralgia, myalgia, headaches, angioedema, dry cough, abdominal pain, diarrhea

chronic: abdominal pain, poor appetite, diarrhea, hepatosplenomegaly, portal HTN, ascites, dyspnea, cor pulmonale, hematuria, pyuria, dysuria, frequency, seizures, sensory/motor impairment, cerebellar syndrome

321
Q

Plasma cell Microscopic Anatomy

A

clock face chromatin distribution and eccentric nucleus,

322
Q

Plasma cell Origins

A

spleen and lymph node

323
Q

Plasma cell Maturation

A

bone marrow

324
Q

Plasma cell function

A

large amounts of antibody specific to particular antigens

325
Q

Plasma cell regulation

A

transcription factors

326
Q

Plasma cell synthesis

A

antigen-activated B in spleen and lymph node -> plasmablast -> plasma cells

327
Q

Plasma cell degradation

A

2-3 days

328
Q

How does hepcidin effect iron levels in body?

A

inhibits ferroportin-1

NPLEX I (2022) (20 decks)

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