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Hematology > Episode 8-HemePath > Flashcards

Episode 8-HemePath Flashcards

1
Q

What are the three CBC tests that can demonstrate anemia?

A

1.MCHC 2.Hematocrit 3.RBC count

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2
Q

Pallor,Tachycardia / Palpitations, Worsening of angina are some of the less common symptoms of what condition?

A

Anemia

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3
Q

What are the four basic causes of acquired anemias?

A

1.Specific Deficiencies (iron, B12, B9) 2.Blood Loss (acute or chronic) 3. Chronic Disease (TONS) 4.Hemolysis (aquired autoimmune hemolytic anemia)

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4
Q

HE LOVES THIS QUESTION STYLE: What is the MOST COMMON cause of anemia worldwide?

A

Iron Deficient Anemia

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5
Q

What are the two results of iron deficient anemia? Which CBC tests do we use to see these results?

A

MicroCytic (MCV decreased) and HypoChromic (MCH & MCHC decreased)

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6
Q

Which anemia is associated with PENCIL CELLS? This occurs because of unbalanced surface membrane to _______ due to reduced _________.

A

Iron Deficient Anemia….cytoplasmic volume….hemoglobin

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7
Q

A reduced rate of _________ synthesis results in more cell division and subsequently smaller cells. Lower levels of hemoglobin in the RBCs make them appear “______”.

A

hemoglobin…“pale”

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8
Q

What is the molecule that binds iron in the blood? What is the molecule that stores iron in the liver?

A

Transferrin in the blood, Ferritin in the liver

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9
Q

What is the major cause of Iron deficiency?

A

Overt or Occult BLOOD LOSS

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10
Q

What are: traumatic hemorrhage, hematemesis, melena, hemoptysis, severe menorrhagia, and gross hematuria ALL EXAMPLES OF?

A

OVERT blood loss

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11
Q

What are the four main causes for iron deficient anemia?

A

1.Blood Loss 2.Drecreased Iron Absorption 3.Diet 4.Inreacsed Iron requirements

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12
Q

What can a problem with the GI tract (e.g., bleeding ulcer, inflammatory bowel disease, etc.) or an issue with a drug impairing iron absorption lead to?

A

Iron deficient anemia c/o decreased iron absorption

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13
Q

Which cause for Iron deficient anemia is most common for vegans and elderly?

A

Lack of iron in DIET

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14
Q

What can result if a child is growing (in the womb or out) and they are not receiving enough iron?

A

Iron deficient anemia c/o changing Iron requirements

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15
Q

Decreased vitamin B12 levels produce RBCs that are _________ (_______ is elevated).

A

MACROCYTIC….MCV

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16
Q

What is another name for Vitamin B12 deficient anemia?

A

MEGALOBLASTIC ANEMIA

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17
Q

All actively dividing RBCs in the bone marrow require DNA synthesis in order to undergo mitosis. The metabolic pathways involved in replication of DNA are complex, and involve both ________ and ______.

A

vitamin B12…. folate.

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18
Q

Which cellular process is not affected in Megaloblastic anemia?

A

RNA Synthesis…proteins keep building up inside the cell

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19
Q

What is needed to absorb Vitamin B12 in the gut? What type of anemia is the result if this is not present?

A

Intrinsic Factor….PERNICIOUS ANEMIA

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20
Q

What are the two causes for a lack of Intrinsic factor?

A

AutoImmune Attack on:1. The Intrinsic Factor itself or 2.The PARIETAL cells in the STOMACH

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21
Q

What is the result of an autoimmune attack on Parietal Cells of the stomach (OTHER then pernicious anemia :))

A

Chronic Atrophic Gastritis

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22
Q

Recap: What are the three ways of developing a Vitamin B12 deficient anemia?

A
  1. Lack of IF (Pernicious Anemia) 2.Diet(strict vegans) 3.Gastric Bypass Surgery!
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23
Q

Which deficiency produces the same clinical features as vitamin B12 deficiency?

A

Folate deficient anemia

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24
Q

What are the two key players in DNA synthesis in respect of this lecture?

A

Vitamin B12 and Folate

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25
Q

Does Folate require intrinsic factor to be absorbed?

A

NO!

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26
Q

In which anemia does the MCV remain normal? This anemia is described as __________.

A

Acute Blood Loss Anemia…..NORMOCYTIC

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27
Q

Which type of blood loss is associated with iron deficient anemia in the developed world?

A

Chronic Blood Loss Anemia

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28
Q

Why can renal failure cause anemia?

A

Less ErythroPOetin!!

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29
Q

_________ anemias are disorders in which the red cells are destroyed faster than normal. What is the long, fancy name for this?

A

Hemolytic, AIHA (aquired autoimmune hemolytic anemia)

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30
Q

What are the three categories of inherited anemias?

A

1.Red Cell Membrane(hereditary spherocytosis, elliptocytosis) 2.Red Cell Enzymes (G6DP deficiency) 3.Hemoglobin Molecules(sickle cell, thalassemia)

31
Q

Which genes are affected in Elliptocytosis?

A

The same ones as spherocytosis!! Spectrin, Ankyrin, Band 3 and Protien 4.2

32
Q

The defects of Elliptocytosis destabilize the________ ________ of cells and the cells go poof!

A

cytoskeletal scaffolding

33
Q

Osmotic fragility is a test used to detect _________ and ________.

A

spherocytosis….elliptocytosis

34
Q

What is calculated int he osmotic fragility test? How much of the cells lyse at this amount of osmotic pressure?

A

The Mean Corpuscular Fragility (MCF)..Where 50% of the cells lyse

35
Q

What is the MOST COMMON enzymatic disorder in the WORLD affecting over 400 million people?? What type of genetic disorder is it?

A

Glucose-6-Phosphate Dehydrogenase (G6PD)…X linked

36
Q

G6PD is the only source for ____ in the RBC. What is the function for this molecule?

A

NADPH…Keeps GLUTATHIONE in REDUCED form!!

37
Q

What are the two characteristics of RBCs in G6PD deficiency?

A

Heinz Bodies (cluster of denatured hemoglobin..olive w/ dot) and Bite Cells (look like bites have been taken out by the spleen!)

38
Q

Sickle cell disease results from a _____ mutation in the _____ globin gene, resulting in a change of amino acid number 6 (___—-> ___). The resultant hemoglobin produced by the faulty gene is referred to as _______ __ (___).

A

point…Beta…Glu (Glutamine)—->Val (Valine)….hemoglobin S (HbS) (HbShitty! or HbSickle)

39
Q

In sickle cell anemia, these RBCs to do not flow well through small vessels, and are more adherent than normal RBCs to vascular endothelium, leading to vascular ______ and sickle cell ______.

A

occlusion…crises

40
Q

__________ arises as a result of diminished or absent production of one or more of the globin chains.

A

Thalassemia

41
Q

What is the end result for thalassemia?

A

Chronic Hemolysis…WEIRD!

42
Q

Where do Thalassemia’s occur?

A

Same places as Sickle cell! (Africa, Medit, Mid East, Asia, India)

43
Q

How is Thalassemia classified?

A

After the gene associated…“alpha-thalassemia”=alpha glob in chain alteration

44
Q

The consequence of impaired production of glob in chains in thalassemia leads to RBCs being __________ and _________.

A

MICROCYTIC…..HYPOCHROMIC

45
Q

Leukemia literally means “white blood”, so-called because of the ________ numbers of white cells in the peripheral blood of patients with leukemia at the time of diagnosis. The cancer occurs with white blood cell _______.

A

ENORMOUS….precursors

46
Q

What are the two forms of Leukemia?

A

Chronic and Acute

47
Q

_____ _______ tends to present more dramatically, and must be treated early or death will occur within a short period of time.

A

Acute leukemia

48
Q

In general, _______ ________ is more indolent (slow growing) and in some cases may not require therapy for years. They can be discovered by chance!

A

chronic leukemia

49
Q

In both acute and chronic leukemias, there is progressive accumulation of abnormal white blood cells in the_____ ______ and other organs, which spill out into the peripheral blood.

A

Bone Marrow

50
Q

In leukemia, patients tend to also have a reduced number of ______ and _________.

A

RBCs and megakaryocytes (High WBCs, Low RBCs, Low Platelets)

51
Q

What does AML stand for?

A

Acute Myeloid Leukemia

52
Q

What are the three WBCs that come from the Myeloid line?

A

Basophils, Eosinophils, and Neutrophils (ALL the granulocytes)

53
Q

What is the most common acute leukemia affecting Adults?

A

AML

54
Q

What are the 5 main symptoms of AML?

A

1.Anemia (and all that comes with it) 2.Suseceptible to infection (low lymphocytes) 3.Brusing/Bleeding (low Platelets) 4.Bone Pain 5.Respiratory/Neruo Manifestations (c/o high viscosity “sludging” of blood)

55
Q

What does ALL stand for?

A

Acute Lymphoblastic Anemia

56
Q

What are the three cells of the lymphocyte line?

A

1.B-Lymphocytes 2.T-Lymphocytes 3.Natural Killer Cells

57
Q

Which acute leukemia is most common in childhood? About when does it occur?

A

Acute Lymphocytic Leukemia…2-5 years of age

58
Q

What are the 5 main symptoms of ALL?

A

1.Anemia (and all that comes with it) 2.Suseceptible to infection (low lymphocytes) 3.Brusing/Bleeding (low Platelets) 4.Bone Pain 5.Respiratory/Neruo Manifestations (c/o high viscosity “sludging” of blood)

59
Q

Which leukemia has the “Philadelphia” chromosome?

A

Chronic Myeloid Leukemia

60
Q

When in life is Chronic Myeloid Leukemia presentation most common?

A

Between 40-60 Years of age

61
Q

Which two chromosomes are swapping in the Philadelphia chromosome?

A

Philadelphia Chromosome = Top of Chromosome #22 + Bottom of Chromosome #9 (AND VICE VERSA!)

62
Q

The Philadelphia Chromosome mutation of CML leads to transcription of proteins with high ______ _______ activity.

A

tyrosine kinase

63
Q

What are the three phases of CML?

A

1.Chronic Phase (Asymptomatic..left side pain, abdominal swelling) 2.Accelerated Phase 3.Blast Crisis (resembles acute leukemia)

64
Q

Which CML phase are 85% of patients at during diagnosis?

A
  1. Chronic Phase
65
Q

What does CLL stand for?

A

Chronic Lymphoblastic/Lymphocytic Leukemia

66
Q

What is the MOST common adult leukemia?

A

CLL

67
Q

What is the male:female ration of CLL? When is the peak incidence?

A

2male:1female..60-80yrs old

68
Q

In contrast to Leukemias, lymphomas are _____ ______ _____ and can originate within many different lymphoid tissues, namely the ______ ______ (which is the most common), spleen, liver, GI tract, thymus or bone marrow.

A

solid tumor masses….lymph nodes

69
Q

What causes Hodgkin’s Lymphoma?

A

UNKNOWN!

70
Q

What are the 6 presentations of Lymphoma?

A

1.Itchy Skin 2.Night Sweats 3.Weight Loss 4.ENLARGED LYMPH NODES 5.Splenomegaly 6.Hepatomegaly

71
Q

___________ cells (“______ cells”) are characteristically seen when lymph nodes are biopsied in Lymphoma; these are B lymphocytes that have lost the ability to produce _______.

A

Reed-Sternberg cells (“popcorn cells”)….anitbodies

72
Q

Basically, __________ are a group of lymphomas that include everything but Hodgkin’s lymphoma.

A

Non-Hodgkin’s Lymphomas

73
Q

What is more common: Hodgkins or Non-Hodgkins?

A

Hodgkins (2-3:100,00people) vs (66,000 new cases per year)

74
Q

What are the symptoms of Non-Hodkins Lymphoma?

A

1.Itchy Skin 2.Night Sweats 3.Weight Loss 4.ENLARGED LYMPH NODES 5.Splenomegaly 6.Hepatomegaly

Hematology (8 decks)

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