Heme Flashcards

1
Q

increased band cells

A

increased myeloid proliferation

CML, bacterial infections

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2
Q

CD14

A

surface marker for macrophages

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3
Q

eosinophils produce

A

histaminase

arylsulfatase

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4
Q

eosinophil defend against

A
neoplastic
asthma
allergic
collagen vascular dz
parasites
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5
Q

basophil

A

allergic rxn

heparin, histamine, leukotrienes

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6
Q

Dendritic cells

A
express MHC class II and Fc receptor
called Langerhan's cells in skin
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7
Q

lymphocytes

A

divide into B and T cells

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8
Q

Leukocytes

A

granulocytes –> basophil, neutrophil, eosinophil

mononuclear - monocytes, lymphocytes

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9
Q

Kallikrein

A

activates bradykinin

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10
Q

ACE

A

inactivates bradykinin

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11
Q

Warfarin

A

inhibits epoxide reductase

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12
Q

Vit K def

A

decreased synthesis of 2,7,9,10, protein C and S

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13
Q

Heparin

A

activates antithrombin

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14
Q

antithrombin

A

inhibits 2,7,9,10,11,12

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15
Q

protein c

A

inactivates V

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16
Q

V

A

prothrombin to thrombin

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17
Q

thrombin

A

fibrinogen to fibrin monomers

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18
Q

Ticlopidine

A

inhibits ADP induced expression of GpIIb/IIIa

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19
Q

Clopidogrel

A

inhibits ADP induced expression of GpIIb/IIIa

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20
Q

decreased ESR

A

polycythemia
sickle cell
CHF
hypofibrinogenemia

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21
Q

4 gene deletion of alpha

A

excess gamma-globin –> forms Hb barts

hydrops fetalis

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22
Q

HbH disease

A

3 gene deletion of alpha

excess beta, B4 –> HbH

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23
Q

cis alpha deletion

A

asian

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24
Q

trans alpha deletion

A

african

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25
Q

B thal minor

A

asymptomatic

increase HbA2

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26
Q

B thal major

A
severe anemia requiring blood transfusion
marrow expansion --> crew cut --> skeletal deformitins
increased HbF (alpha2gamma2)
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27
Q

HbS/B thal

A

mild to moderate sickle cell dz depending on amount of B globin produced

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28
Q

lead inhibits

A

ferrochelatase and ALA dehydratase

decreases heme synthesis

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29
Q

treatment for lead poisoning

A

dimercaprol

EDTA

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30
Q

sideroblastic anemia

A

x linked defect in ALA synthase gene

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31
Q

treatment for sideroblastic anemia

A

pyroidoxine

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32
Q

ACD

A

increased hepcidin

increased ferritin

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33
Q

Causes of aplastic anemia

A

rdiation, drugs
viruses
Fanconi

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34
Q

Hereditary Spherocytosis Cause

A

defect in RBC membrane, ankryin, spectrin

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35
Q

Paroxysmal noctural hemoglobinuria triad

A

hemolytic anemia
pancytopenia
venous thrombosis

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36
Q

PNH Cause

A

impaired synthesis of GPI anchor/CD55,59

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37
Q

HbS mutation

A

glutamic acid —> valine

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38
Q

Warm Autoimmune hemolytic anemia

A

IgG

SLE, CLL, alpha-methyldopa

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39
Q

Cold Autoimmune hemolytic anemia

A

IgM

Mycoplasma, Mono, CLL

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40
Q

Microangiopathic anemia

A

DIC, TTP-HUS, SLE, malignant HTN

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41
Q

macroangiopathic anemia

A

prosthetic heart valves

aortic stenosis

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42
Q

Acute Intermittent Porphyria

A

uroporphyrin in urine

painful abdomin, port wine colored urine, polyneuropathy, psych disturbances, precipitated by drgs

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43
Q

Acute Intermittent Porphyria treatment

A

glucose and heme (inhibit ALA synthase)

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44
Q

PT test

A

extrinsic pathway

1,2,5,7,10

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45
Q

PTT

A

intrinsic

all except 7 and 13

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46
Q

Bernard-Soulier syndrome

A

defect in platelet plug formation, decreased GpIb
decreased platelet count
increased bleeding time

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47
Q

Glanzmann’s thrombasthenia

A

decreased GpIIb/IIIa

increased bleeding time only

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48
Q

ITP labs

A

decreased platelet count
increased bleeding time
increased megakaryocytes

49
Q

ITP cause

A

antibodies against anti-GpIIb/IIIa

50
Q

TTP cause

A

def of ADAMTS 13

51
Q

ADAMTS 13

A

vwF metalloprotease

52
Q

TTP Labs

A

decreased platelet count
increased bleeding time
increased LDH

53
Q

TTP symptoms

A

fever, thrombocytopenia, maha

renal and neuro symptoms

54
Q

Von Willebrand’s disease labs

A

increased BT

normal or increased PTT

55
Q

von willebrand’s disease treatment

A

desmopression

56
Q

DIC labs

A

decreased platelets, fibrinogen, factors V and VIII

increased BT, PT, PTT

57
Q

Burkitt’s lymphoma

A

8:14
c-myc
starry sky
EBV

58
Q

Diffuse large B-cell lymphoma

A

NHL, older adults

59
Q

Mantle Cell lymphoma

A

11:14, cyclin D1

CD5+ poor prognosis

60
Q

Follicular Lymphoma

A

14:18, bcl-2

61
Q

bcl-2

A

inhibits apoptosis

62
Q

Adult T-cell lymphoma

A

HTLV-1

63
Q

Waldenstrom’s macroglobulinemia

A

IgM

hyperviscosity

64
Q

Tdt+

A

ALL

65
Q

CALLA+

A

ALL

66
Q

t:(12;21)

A

better prognosis in ALL

67
Q

ALL

A

<15
mediastinal mass
increased lymphocytes

68
Q

CLL

A

> 60 years

smudge cells

69
Q

Hairy Cell Leukemia

A

B cell

+trap

70
Q

cladribine

A

treatment for hairy cell lymphoma

71
Q

AML

A

65, Auer rods
DIC common
15:17 subtype

72
Q

CML

A

30-60 years, philadelphia chromosome

73
Q

Langerhans cell histiocytosis

A

lytic bone lesions, rash in children
neural crest origin
birbeck granules

74
Q

Essential thrombocytosis vs Polycytehmia

A

RBCs and WBCs elevated in polycythemia

75
Q

essential thrombocytosis

A

specific for megakarogylces, so increased platelets

76
Q

Myelofibrosis

A

tear drop cell

77
Q

enoxaparin, dalteparin

A

low weight molecular heparins

78
Q

heparin toxicity

A

protamine sulfate

79
Q

lepirudin, bivalirudin

A

inhibits thrombin

alternative to heparin

80
Q

Heparin Monitoring

A

PTT

81
Q

Warfarin MOnitoring

A

PT/INR

82
Q

thrombolytics MofA

A

aid conversion of plasminogin to plasmin

83
Q

cliostazol, dipyridamole

A

phosphodiesterase III inhibitor

inhibit platelet aggregation, vasodilate

84
Q

Cancer drugs - S phase

A

etoposide

antimetabolites

85
Q

5-FU

A

colon cancer

photosensitivity

86
Q

5-FU rescue

A

thymidine

87
Q

Cytarabine

A

for leukemias, lymphomas

88
Q

Azathiprine

A

for leukemias

increased toxicity with allopurinol

89
Q

Dactinomycin

A

intercalates DNA

wilm’s tumor, Ewing’s sarcoma, rhabdomyosarcom (child’s tumors)

90
Q

Doxorubicin

A

solid tumors, leukemias, lymphomas

cardiotoxiciticty/dialted cardiomyopathy

91
Q

Bleomycin

A

breaks DNA strands
testicular cancer, Hodgkin’s
pulmonary fibrosis

92
Q

Nitrosoureas

A

brain tumors (CNS toxicity)

93
Q

Busulfan

A

alkylates DNA
CML
pulmonary fibrosis, hyperpigmentation

94
Q

Vincristine/vinblastine

A

solid tumors, leuk, lymph

peripheral neuropathy

95
Q

Paclitaxel

A

ovarian and breast carcinoms

96
Q

Cisplastin/carboplatin

A

testicular/bladder/ovary/lung

nephrotoxicity and acoustic nerve damage

97
Q

Etoposide, teniposide

A

inhibit topoisomerase II

alopecia

98
Q

Tamoxifen, raloxifene

A

SERMs
breast cancer, osteoporosis
hot flashes, increase risk of endometrial cancer

99
Q

trastuzumab toxicity

A

cardiotoxciity

100
Q

Vemurafenib

A

inhibitors B-Raf kinase

metastatic melanoma

101
Q

Septic Shock

A

decrease PVR
increased CO
decreased PCWP

102
Q

Cardiogenic Shock

A

increased PVR
decreased CO
increased PCWP

103
Q

aminolevulinic acid synthase

A

sideroblastic anemia

104
Q

aminolevulinic acid dehydratase

A

lead poisoning

105
Q

proprhobilinogen deaminse

A

acute intermittent porphyria

106
Q

ferrochelatase

A

lead poisoning

107
Q

procarbazine

A

hodgkin’s lymphoma
MAOI
avoid tyramine containing food

108
Q

DIC

A

activation of coagulation cascade

109
Q

treatmetn for methemoglobinemia

A

methylene blue

110
Q

salicylate toxicity

A

tinnitus

resp alk + anion gap meta acid

111
Q

DIC associated with

A

AML

112
Q

blast crisis

A

CML

113
Q

autoimmune anemias associated with

A

CLL

114
Q

chloramphenical

A

use for niseeria infections

causes aplastic anemia

115
Q

EBV structure

A

linear, dsDNA, envelope

116
Q

PNH substance in urine

A

hemosiderin

117
Q

one unit of blood

A

increases hematocrit by 3%

118
Q

chloramphenicol mofa

A

binds 50S