14. Hematology Flashcards Preview

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Flashcards in 14. Hematology Deck (25):
1

Intrinsic vs. extrinsic hemolytic anemia?

Intrinsic - something wrong with the RBC that causes it to hemolyze vs. extrinsic - RBC is totally fine and something bad happens to it

2

Lack of central pallor?

Hereditary spherocytosis

3

What's the inheritance of hereditary spherocytosis?

Autosomal dominant

4

Why do patients with spherocytosis have splenomegaly?

Spleen is what clears these cells

5

What is the diagnostic test for spherocytosis?

Osmotic fragility

6

What is the treatment for spherocytosis?

Splenectomy

7

At what percentage of HbS do you get sickling?

60% - can get spontaneous sickling

8

Why do we get pain crises in sickle cell?

Vasoocclusion from sickle cells --> ischemia --> pain

9

What happens to the spleen eventually in sickle cell?

Autosplenectomy

10

What does Howell Jolly bodies tell you about the spleen?

Spleen isn't working; splenic macrophages should remove Howell Jolly

11

When can a kid get their first sickling crisis (dactylitis)?

6 - 9 months of age because HbF inhibits sickling (protective for newborns)

12

What is the cause of osteomyelitis in sickle cell patients?

Salmonella (encapsulated)

13

What drug can we give for sickle cell?

Hydroxyurea - promotes HbF synthesis

14

What are the genetics of G6PD deficiency?

X linked recessive

15

Why do we need G6PD?

To regenerate glutathione so we can neutralize peroxide

16

What 2 drugs should you associate with G6PD hemolysis?

Primaquine, dapsone

17

What is the most common autoimmune hemolysis?

IgG from SLE

18

Direct vs. indirect Coombs?

Direct - IgG/C3b directly on RBC's vs. Indirect - Ab in the serum

19

Drugs that induce hemolytic anemia?

PCN (attaches to RBC), methyldopa (alters Rh antigens on RBC), quinidine (hapten)

20

PCN - rash, type of HSR?

I

21

PCN - hemolytic anemia, type of HSR?

II

22

Quinidine - hemolytic anemia, type of HSR?

III - immune complex with IgM

23

Methyldopa - hemolytic anemia, type of HSR?

II

24

What causes leukemoid reaction?

Usually infection (overexaggerated response)

25

What cell does EBV infect?

B cell (CD 21)