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Flashcards in Hematology Deck (153)
1

What is a Neutrophil?

The phagocyte (has anti-microbials, most abundant)

2

What is a Eosinophil?

The parasite destroyer, allergy inducer

3

What is a Basophil?

The Allergy Helper (IgE receptor=> histamine release)

4

What is a Monocyte?

The Destroyer=> MP (hydrolytic enzymes, coffee-bean nucleus)

5

What is a Lymphocyte?

The Warrior=>T, B, NK cells

6

What is a Platelet?

The Clotter (no nuclei, smallest cells)

7

What is a Blast?

Baby Hematopoietic cell

8

What is a Band?

Baby Neutrophil

9

What does high WBC and high PMNs tell you?

Stress demargination

10

What does high WBC and <5% blasts tell you?

Leukemoid reaction, seen in burn patients (extreme demargination looks like leukemia)

11

What does high WBC and > 5% blasts tell you?

Leukemia

12

What does high WBC and bands tell you?

Left shift=> have infection

13

What does high WBC and B cells tell you?

Bacterial infection

14

What diseases have high eosinophils?

"NAACP"

Neoplasm
Allergy/ Asthma
Addisons disease (no cortisol -> relative eosinophilia
Collagen vascular disease
Parasites

15

What diseases have high monocytes (>15%)?

"STELS"

Syphilis: chancre, rash, warts
TB: hemoptysis, night sweats
EBV: teenager sick for a month
Listeria: baby who is sick
Salmonella: food poisoning

16

What do high retics (>1%) tell you?

RBC being destroyed peripherally

17

What do low retics tell you?

Bone marrow not working right (decrease production)

18

What is Poikilocytosis?

Different shapes

19

What is Anisocytosis?

Different sizes

20

What is the RBC lifespan?

120 days

21

What is the platelet lifespan?

8-10 days

22

What does -penia tell you?

Low levels (usually due to virus or drugs)

23

What does -cytosis tell you?

High levels

24

What soes -cythemia tell you?

High levels

25

What is the difference between plasma and serum?

Plasma:no RBC
Serum:no RBC or fibrinogen

26

What is Chronic Granulomatous Disease?

NADPH oxidase deficiency -> recurrent Staph/Aspergillus infections (Nitroblue Tetrazolium stain negative)

27

What does MPO deficiency cause?

Catalase + infections

28

What is Chediak Higashi?

Lazy lysosome syndrome: lysosomes are slow to fuse around bacteria

29

What organ can make RBCs if the longbones are damaged?

Spleen => splenomegaly

30

What causes a shift to the right in the Hb curve?

"All CADETs face right"

^CO2
Acid/Altitude
2,3-DOG
Exercise
Temp

31

How does CO poison Hb?

Competitive inhibitor of O2 on Hb => cherry red lips, pinkish skin hue

32

How does Cyanide poison Hb?

Non competitive inhibitor of O2 on Hb => almond breath

33

What is MetHb?

Hb w/ Fe+3

34

What is Acute Intermittent Porphyria?

^Porphyrin, urine delta-ALA, porphobilinogen => abdominal pain, neuropathy, red urine

35

What is Porphyria Cutanea Tarda?

Sunlight=> skin blisters w/porphyrin deposits,
Woods lamp= orange-pink

36

What is Erythrocytic Protoporphyria?

Porphyria cutanea tarda in a baby

37

What is Sickle cell disease?

Homozygous HbS: (BGlut6->Val) vaso-occlusion, necrosis, dactylitis (painful fingers/toes) at 6mo, protects against malaria

38

What is Sickle cell trait?

Heterozygous HbS => painless hematuria, sickle with extreme hypoxia (can't be a pilot, fireman, diver)

39

What is Hb C disease?

(BGlu6->Lys), still charged => no sickling

40

What is alpha-thalassemia?

1 deletion:normal
2 deletions "trait": Microcytic anemia
3 deletions: Hemolytic anemia, Hb H=B4
4 deletions: hydrops fetalis, Hb Bart= Gamma 4

41

What is B thalassemia?

1 deletion "B minor": ^HbA2 and HbF
2 deletions "trait/intermedia/major": only HbA2, and HbF => hypoxia at 6 months

42

What is Cooley's anemia?

See w/B thalassemia major (o HbA=>excess RBC production); baby making blood from everywhere=> frontal bossing hepatosplenomegaly, long extremities

43

What is Virchow's triad?

Thrombosis risk factors:
1) Turbulent blood flow "slow"
2)Hypercoagulable "sticky"
3)Vessel wall damage "escapes"

44

What does acute hypoxia cause?

Shortness of breath

45

What does chronic hypoxia cause?

Clubbing of fingers/toes

46

What is intravascular hemolysis?

RBC destroyed in blood vv. -> low haptoglobin (bind free floating Hb)

47

What is extravascular hemolysis?

RBC destroyed in spleen (problem w/RBC membrane) => splenomegaly

48

What enzyme need lead (Pb)?

delta- ALA dehydrase
Ferrochelatase

49

What does EDTA bind?

X2+

50

What disease has a smooth philthrum?

Fetal alcohol syndrome

51

What disease has a long philthrum?

William's

52

What disease has a sausage digits?

Pseudo-hypoparathyroidism, psoriatic arthritis

53

What disease has 6 fingers?

Trisomy 13

54

What disease has 2 joined thumbs?

Diamond-Blackfan

55

What disease has painful fingers?

Sickle cell disease

56

What are the Microcytic Hypochromic anemias?

"FAST Lead"
Fe deficiency
Anemia of chronic disease
Sideroblastic anemia
alpha-Thalasemmia
B-Thalasemmia
Pb poisoning

57

Fe deficiency

^ TIBC, menses, GI bleed, koilonychia

58

Anemia of Chronic Disease

decrease TIBC

59

Sideroblastic Anemia

decrease Delta-ALA synthase, blood transfusions

60

alpha thalassemia

AA, Asians, (Chromosome 16 deletion)

61

B Thalassemia

Mediterraneans (Chromosome 11 point mutation)

62

Pb poisoning

decrease delta-ALA dehydrogenase, decrease ferrochelatase, x-ray blue line, eating old paint chips

63

What are the Megaloblastic Anemias?

Vit B12 deficiency
Folate deficiency
Alcohol

64

Vit B12 deficiency

Tapeworms, vegans, type A gastritis, pernicious anemia

65

Folate deficiency

old food, glossitis

66

Alcohol

Fetal alcohol syndrome: smooth philthrum, stuff doesn't grow

67

What are the Intravascular Hemolytic Anemias?

IgM

G-6PD deficiency
Cold autoimmune

68

G6PD deficiency

Sulfa drugs, moth balls, fava beans, sudden drop in Hb

69

Cold autoimmune

Mononucleosis, mycoplasma infections, RBC agglutination

70

What are the Extravascular Hemolytic anemias?

IgG

Spherocytosis
Warm autoimmmune
Paroxysmal cold autoimmune
Sickle cell anemia

71

Spherocytosis

Defective spherin or ankyrin, + osmotic fragility test

72

Warm autoimmune

Anti-Rh Ab, dapsone, PTU, anti-malarias, sulfa drugs

73

Paroxysmal cold autoimmune

Bleeds after cold expossure, Donath-Landsteiner Ab

74

Sickle Cell Anemia

Crew haircut x-ray, avascular necrosis of femur, short fingers

75

What are the Production Anemias?

Diamond-Blackfan
Aplastic Anemia

76

Diamond-Blackfan

No RBCs, 2-joined thumbs

77

Aplastic Anemia

Pancytopenia, autoimmune, benzene, AZT, CAM, radiation

78

What is the Basophilic Stippling?

Lots of immature cells, ^mRNA (Pb poisoning)

79

What is a Bite cell=Basket cell?

Unstable Hb inclusions (G6-PD deficiency)

80

What is a Burr cell=Echinocyte?

Pyruvate kinase deficiency, Liver dz, Post-splenectomy

81

What is Cabot's ring body?

Vit B12 deficiency, Pb poisoning

82

What is a Doehle body?

PMN leukocytosis (infection, steroids, tumor)

83

What is a Drepanocyte?

Sickle cell anemia

84

What is a Helmet cell?

Fragmented RBC (Hemolysis: DIC, HUS, TTP)

85

Whats a Heinz body?

Hb precipitates and sticks to cell membranes (G-6PD deficiency)

86

What is a Howell-Jolly body?

Spleen or bone marrow should have removed nuclei fragments (hemolytic anemia, spleen trauma, cancer)

87

What is a Pappenheimer body?

Fe ppt inside cell (sideroblastic anemia)

88

What is a Pencil Cell=Cigar cell?

Fe deficiency anemia

89

What is a Rouleaux formation?

Multiple myeloma

90

What is a Schistocyte?

Broken RBC (DIC, artificial heart valves)

91

What is a Sideroblast?

Macrophages pregnant w/Fe (genetic or multiple transfusions)

92

What is a Spherocyte?

Old RBC

93

What is a Spur cell= Acanthocyte?

Lipid bilayer dz

94

What is a Stomatocyte?

Liver dz

95

What is a target cell=codocyte?

Less Hb (Thallasemias or Fe deficiency)

96

What is a tear drop cell = dandrocyte?

RBCs squeezed out of marrow (hemolytic anemia. bone marrow cancer)

97

What is a clotting cascade?

How you stop bleeding

98

What do platelet problems cause?

bleeding from skin and mucosa

99

What do clotting problems cause?

bleeding into cavities

100

What causes increased PTT and bleeding time?

von Willebrand disease and Lupus

101

What is Bernard-Soulier?

baby w/bleeding from skin and mucosa, big platelets (low GP1b)

102

What is Glanzmann's?

baby w/ bleeding from skin and mucosa (low GP2b3a)

103

How does Factor 1 deficiency present?

Unbilical stump bleeding (1st time baby has to stabilize a clot)

104

What is Factor V Leiden?

Protein C can't break down factor 5=> more clots

105

How does von Willerbrand Disease present?

Heavy menstrual bleeding

106

What are the types of VWD?

Type 1 (AD): decreases VWF production
Type 2(AD): decreases VWF activity (+Ristocetin aggregation test)
Type 3(AD): No VWF

107

What is Hemophilia A?

Defective factor 8 ( bleed into cavities (head, abdomen, etc)

108

What is Hemophilia B?

Factor 9 deficiency=> bleed into joints (knee, etc)

109

What diseases have low LAP?

CML, PNH

110

What has high LAP?

Leukemoid reaction

111

What is the difference between acute and chronic leukemia?

Acute: started in bone marrow, squeezes RBC out of marrow

Chronic: started in periphery, not constrained => will expand

112

What is the difference between myeloid and lymphoid leukemias?

Myeloid: ^RBC, WBC, platelets, MP (decrease lymphoid cells) => bone marrow biopsy

Lymphoid: ^NK, T, B cells (decrease myeloid cells) => do lymph node biopsy

113

What defines ALL?

<15 y/o males, bone pain, PAS stain +, TdT +

114

What defines AML?

15-30 y/o males, Sudan Stain, Auer rods

115

What defines CML?

30-50 y/o females, t (9,22) "philadelphia chromosome", bcr-abl, decrease LAP

116

What defines CLL?

>50 y/o males w/lymphadnopathy, "soccer ball", nuclei, smudge cells

117

What defines Hodgkin's lymphoma?

EBV, may have Reed-Sternberg cells

118

What are the B cel Non-Hodgkins lymphomas?

Follicular: t(14,18), bcl-2
Burkitt: t(8,14), c-myc, starry sky MP
-American kids: abdominal mass
-African kids: jaw mass

119

What are the T cell Non-hodgkins lymphomas?

Mycosis Fungoides: total body rash
Sezary syndrome: cerebreform cells

120

What is Polycythemia Rubra Vera?

Hct>60%, decrease Epo, Budd-Chiari, plethora "pruritis after bathing"

121

What is Essential Thrombocythemia?

Very high platelets, stainable Fe, decrease c-mpl

122

What is Myelofibrosis?

Megakaryocytes, fibrotic marrow=> teardrop cells, extramedular hematopoiesis

123

What are plasma neoplasm?

Produces lots of Ab

124

What is Waldenstrom Macroglobulinemia?

IgM, hyperviscous

125

What is Monoclonal Gammopathy of Undetermined Significance?

Old person w/ gamma spike

126

What is multiple myeloma?

Serum M prot (IgG), urine Bence-Jones protein, rouleaux, punched out lesions

127

What is Heavy Chain Disease?

^IgA

128

What is Hystocytosis X?

Kid w/ eczema, skull lesions, diabetes insipidus, exophthalmos

129

What does the Coombs test tell you?

Ab involved

130

What does the direct Coombs tes tell you?

In serum

131

What is type and cross?

You know you can use that blood, save it for specific pt

132

What is type and match?

Type it and wait

133

What is forward typing?

Uses Ab to detect Ag " Fabulous"

134

What is backward typing?

Uses Ag to detect Ab

135

What does blood type A tell you?

Have the A antigen

136

What does blood type O tell you?

Have no antigens, universal donor

137

What does bloos type AB tell you?

Have both antigens, universal recipient

138

What does Rh + tell you?

Has D antigen

139

What does Rh- tell you?

Does not have D antigen

140

What is Hemolytic Disease of the Newborn?

Rh -Mom's placenta tears, 100 cc baby's blood sees Mom/produces Ab, attack fetus

141

What is RHOGAM?

Anti-D IgG

142

When do you give RHOGAM?

1st dose: 28 wk gestation (of 2nd child)
2nd dose: 72 hrs post delivery (Rh + baby)

143

What is the most common transplant?

Blood

144

What is a Syngenic transplant?

Twin to twin

145

What is an Autograft?

Self to Self transplant

146

What is an Allograft?

Human to Human transplant

147

What is a Xenograft?

1 species to another species

148

What is a Hyperacute rejection?

within 12 hrs (preformed Ab)

149

What is Acute rejection?

4 days to years later (tcells, MP)

150

What is a Chronic rejection?

>7 days (fibroblast)

151

What is a Graft vs Host disease?

Bone marrow transplants reject (T k, MP)

152

What are Immunoprivileged sites?

No lymphatic flow=> no Ag=> easy to transplant (brain, cornea, thymus, testes)

153

What is INR?

Measured PT/ Control PT