First Aid pg 397-401 Heme Flashcards Preview

FIRST aid 2015 - Sahaja > First Aid pg 397-401 Heme > Flashcards

Flashcards in First Aid pg 397-401 Heme Deck (72):
1

What causes cell death due to peroxidation of membrane lipids?

Fe poisoning

2

Symptoms of Fe poisoning?

n/v, gastric bleeding, lethargy, scarring leading to GI obstruction

3

Drugs used for Fe poisoning?

Chelation - IV deferoxamine, oral deferasirox

4

Which factors are tested in PT?

Factors I, II, V, VII, and X

5

Which factors are not tested in PTT?

All factors except VII and XIII

6

Inheritance patterns of all three hemophilias?

Hemophilia A and B - XLR, and C is AR

7

Tx for Hemophilia A?

Desmopressin + factor VIII concentrate

8

Vitamin K def will have an increase in what lab tests?

PT and PTT, Bleeding time is Normal

9

What parts of the coag pathway are affected by Vit K def?

F II, VII, IX, X, and Prot C and S

10

Which 3 hemat diseases have an issue with platelet plug formation?

Both Bernard Soulier, Glanzmann thrombasthenia, vW disease

11

Which platelet disorder has normal platelet count?

Glanzmann , vW disease

12

With which heme disorder will you potentially see enlarged platelets?

Bernard Soulier - release of relatively immature platelets to replace loss.

13

Which heme disorder is associated with inc BUN ?

TTP, DIC, Hemolytic Uremic Syndrome, PNH, Sickle Cell, porphyria, Multple Myeloma

14

What enzyme activates vit K?

vit K epoxide reductase

15

Normal bleeding time?

2-7 min

16

Normal PT time?

11-15 sec

17

Normal PTT time?

25-40 sec

18

Which two hematological disorders affect GpIIb/IIIa? How do they effect it?

Glanzmann - dec levels of GpIIb/IIIa
Immune Thrombocytopenia - anti GpIIb/IIIa antibodies

19

Which hemat disorder show inc megakaryocytes on bone marrow biopsy?

ITP

20

Which hemat disorder has a def of metalloprotease?

TTP - ADAMTS 13 = vWF metalloprotease

21

Schistocytes are seen in which platelet disorder? why?

TTP - due to microthrombi formation (inc vWF multimers --> Inc platelet adhesion --> Inc platelet aggregation and thrombosis) DIC, HUS

22

Which two hemat disorders have neurological symptoms?

TTP and HUS - pentad of neuro/renal symptoms, fever, thrombocytopenia, fever, microangiopathic hemolyic anemia

23

What is the difference between HUS in adults and children?

Children tend to have diarrhea, adults do not.

24

Most common cause of dec platelet #?

ITP

25

Which blood tests are elevated in vW disease?

BT inc, and PTT may be normal or Inc

26

Explain the Ristocetin test result of vW Disease?

No platelet aggregation, without vW.

27

Which two hemat diseases are treated with desmopressin?

Hemophilia A, vW disease (affiliated with FVIII)

28

Causes of DIC?

Sepsis, Trauma, Obstetric complications, acute Pancreatitis, Malignancy, Nephrotic syndrome, Transfusion, Rattlesnake venom , AML

29

Lab values of DIC?

Inc fibrin degradation, dec fibrinogen, Dec factors V and VIII

30

How does Antithrombin deficiency affect PT, PTT, and thrombin time? It can affect which of those values following an admin of which drug?

No direct effect on PT, PTT, or thrombin time. However, it can decrease the level of PTT increase following Heparin admin. (PTT is normally used to follow Heparin admin)

31

Nephrotic syndrome is associated with which two coagulation disorders?

DIC and Antithrombin deficiency

32

What type of mutation in FV Leiden?

DNA point mutation, G --> Arg506Gln

33

The mutation is FV Leiden def stops its degradation by what protein?

Prot C

34

Most common cause of hypercoagulability in Caucasians?

F V Leiden

35

What issue specific to women must one be concerned about in terms of FV Leiden def?

1) Inc risk of PE with OCP
2) Recurrent pregnancy loss

36

Prot C and S def will lead inability to inhibit which factors?

Factor Va and VIIIa

37

Be careful with prescribing which anti-coag when it comes to Prot C or S def?

Warfarin - inc risk of skin necrosis

38

location of Gene mutation of Prothrombin?

Mutation in 3' UTR

39

Risk associated with blood transfusion?

transfusion reactions, Fe overload (could lead to 2ndary hemochromatosis) hypocalcemia, hyperkalemia

40

Viruses associated with Hodgkins and Non Hodgkins lymphoma?

EBV and HIV

41

Which type of lymphoma is assoc with B symptoms? What are those symptoms?

Hodgkin's, low grade fever, night sweats, weight loss

42

CD # of Reed-Sternberg cells?

CD15, CD30

43

What are the two genes affected in Burkitts? (not the translocation itself, but the products of them)

Chr 8 - c -myc
Chr 14 - Ig heavy chain

44

Tingible body macrophages associated with?

Burkitts

45

What type of lesion is seen in the sporadic form of Burkitts?

Pelvis and abdomen lesions

46

Most common type of Non Hodgkin's in adults?

Diffuse large B cell lymphoma

47

Why can blood transfusions lead to tingling sensations and paresthesias?

hypocalcemia

48

Gene products of the genes translocated in Mantle cell lymphoma?

Chr 11 - cyclin D1 (G1--> S)
Chr 14 - Ig heavy chain

49

What are the gene products of the gene translocation of Follicular lymphoma?

Chr 14 - Ig heavy chain
Chr 18 - bcl2

50

Which lymphoma presents with intermittent pain of lymph nodes?

Follicular lymphoma

51

What are the cell types in grades 1-3 of Follicular lymphoma?

Grade 1 - small cleaved cells
Grade 2 - Mixed
Grade 3 - large cells

52

Name an AIDS defining lymphoma?

Primary Central Nervous System Lymphoma

53

Presentation of PCNSL? Assoc with which virus?

Confusion, memory loss, seizures - assoc with EBV

54

3 diseases with mass lesions in CNS?

Toxoplasmosis, PCNL, GBM

55

Which lymphoma is associated with cutaneous lesion and tremor?

ATCL (Adult T cell ), tremor due to hypercalcemia, also associated with lytic bone lesions

56

Which condition is associated with lymphocytes with cerebriform nuclei? What CD #?

Mycosis Fungoides, CD 4+

57

Ig associated with M spike in Mult myeloma and in Waldenstrom macroglobulinemia?

MM - IgG, IgA
WM - IgM

58

What does the M in M spike mean?

M is not for IgM, but for Monoclonal - one clonal type of Ig

59

What type of amyloidosis seen in MM?

Primary (AL)

60

What are Bence Jones proteins?

Ig light chains

61

Name two signs of MM you'd see in a blood smear?

Stacked RBC (rouleaux) and plasma cells with "clock face" chromatin

62

The intracytoplasmic inculsions of plasma cells in MM contain what?

Ig

63

Clinical diff between MGUS and MM?

There are no Crab findings -
C - HyperCalcemia
R - Renal issues (due to BJ prot blocking tubules)
A - Amyloid, Anemia (plasma cells taking BM)
B - Bone lytic lesions, Back pain, Bence- Jones

64

What hematological issue has visual defect, bleeds, strokes, Raynauds?

Waldenstrom Macroglobulinemia - Sx from hyperviscosity

65

Neutrophils with bilobed nuclei seen after chemo?

Pseudo Pelger Huet anomaly

66

Causes of MDS?

de novo mutations, environmental (radiation, benzene, chemo)

67

MDS can lead to what type of leukemia?

AML

68

What is the Warburg effect, esp in relation to Burkitt's

Cmyc - nucl phosphated prot --> transcription of activator that controls cell proliferation, differentiation, and apoptosis --> leads to upreg of anaerobic gycolysis = Warburg Effect

Warburg Effect - is the observation that most cancer cells predominantly produce energy by a high rate of glycolysis followed by lactic acid fermentation in the cytosol, rather than by a comparatively low rate of glycolysis followed by oxidation of pyruvate in mitochondria as in most normal cells.

69

Desmopressin also used in what neuro issue?

Enuresis

70

What disease looks very similar clinically to FV Leiden def?

Anti phospholipid syndrome

71

Deferoxamine is also used in what chemo drug tox?

Doxorubicin

72

MDS is most common acquired cause of heme issues?

Sideroblastic anemia