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Hematology Flashcards

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1
Q

anemia

A

Anemias are classified by causes or changes that affect the size, shape, or substance of the erythrocyte

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2
Q

cytic

A

cell size

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3
Q

chromic

A

hemoglobin content

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4
Q

anisocytosis

A

various sizes

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5
Q

poikilocytosis

A

various shapes

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6
Q

Anemia Fundamental Alteration

A

reduced oxygen carrying capacity of blood resulting in hypoxia

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7
Q

reduction of blood cells leads to…

A

reduction of consistency and volume of blood -> interstitial fluid pulled into blood -> alters viscosity and makes flow more turbulent -> hyperdynamic circulatory state -> increased stroke volume and heart rate -> cardiac dilation and heart valve insufficiency

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8
Q

macrocytic-normochromic anemias

A

large stem cells in marrow that mature to erythrocytes that are very large in terms of volume, size, and thickness

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9
Q

Pernicious Anemia (PA)

A

most common and caused by B12 deficiency

often accompanies end stage of type A chronic atrophic gastritis (autoimmune)

pernicious means highly destructive (used to be fatal)

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10
Q

PA (patho)

A

lack of intrinsic factor (IF)- required for gastric absorption of B12

may be congenital or b/c of adult onset gastric mucosal atrophy

autoimmune, heavy alcohol ingestion, hot tea, and cigarette smoking are causes

complete or partial removal of the stomach leads to IF deficiency

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11
Q

PA (mani)

A

develops slowly (20-30 years) - so usually severe by time treatment is sought

classic symptoms at hemoglobin levels of 7-8 g/dL (weakness, fatigue, paresthesias of feet and fingers, difficulty walking, loss of appetite, abdominal pain, weight loss, and sore tongue that is smooth and beefy red), skin may become “lemon yellow” (sallow)(combo of pallor and jaundice)

hepatomegaly (Right Heart Failure) and splenomegaly

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12
Q

Folate Deficiency (folic acid)

A

essential vitamin for RNA and DNA production in RBC (completely dietary -50-200 mg/day)

more common than PA

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13
Q

Microcytic-hypochromic anemia

A

abnormally small RBCs with reduced hemoglobin

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14
Q

Iron Deficiency Anemia (IDA)

A

most common in the world

poverty, women of childbearing age, children at highest risk

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15
Q

Stages of IDA

A 
1 = iron stores depleted (RBC and hemoglobin levels normal)
2 = iron deficient RBC production
3 = hemoglobin deficient RBCs replace normal RBCs in circulation
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16
Q

Sideroblastic Anemia (SAs)

A

a group of heterogeneous disorders characterized by anemia of varying severity b/c of inefficient Fe uptake

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17
Q

Acquired SA

A

most common, idiopathic, associated with other myeloproliferative or myeloplastic disorders

secondary to alcoholism, drug reactions, CU deficiency, and hypothermia

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18
Q

Hereditary SA

A

rare, almost exclusively in males (X-linked recessive)

present in infancy and childhood, but not detected until midlife when other issues (DM or Cardiac failure) happen

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19
Q

Reversible SA

A

associated w alcoholism which results from nutritional deficiencies of folate (also, some drugs and Cu deficiency)

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20
Q

Sideroblastic Anemia (SAs) - manifestations

A

Cardiovascular and respiratory b/c of Fe overload (hemosiderosis)

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21
Q

Normocytic-normochromic anemias (NNAs)

A

characterized by erythrocytes that are relatively normal in size and hemoglobin content but insufficient in number

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22
Q

Aplastic (patho)

A

Rare; may result from radiation; drugs; lesions within bone marrow immune response halt erythropoiesis.(Fanconi anemia) autoim mune diseases, renal failure, splenic dysfunction, vitamin B12 or folate deficiency

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23
Q

Aplastic (mani)

A

Typical: petechiae; ecchymosis;bleeding;infection;pancytopenia (deficiency of all three cellular components of the blood (red cells, white cells, and platelets)

high risk group: anyone

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24
Q

Posthemorrhagic

A

sudden and acute blood loss

high risk group: surgery, trauma

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25
Hemolytic (patho)
Premature dysfunction or destruction of mature erythrocytes in circulation, genetics, resulting in fragile cells;acquired from infections, drugs, autoimmunity warm immunoglobulin G (IgG) or cold (IgM) antibodies high risk group: anyone
26
Hemolytic (mani)
Splenomegaly; jaundice
27
Polycythemia
Excessive red cell production
28
Relative Polycythemia
results from hemoconcentration of the blood associated with dehydration minor consequence, resolved with fluid administration
29
Absolute Polycythemia
consists of i)primary and ii) secondary
30
Primary polycythemia (Polycythemia Vera (PV)
chronic, clonal alteration characterized by overproduction of red cells(frequently with increased white cells and platelets) accompanied by splenomegaly
31
Primary polycythemia (patho)
Characterized by an abnormal proliferation of bone marrow stem cells, with subsequent self-destructive expansion of red blood cells
32
Primary polycythemia (mani)
due to increased blood volume, which increases blood viscosity, resulting in clogging and occlusion of blood vessels tissue Injury, (ischemia) and death (infarction) is the outcome of blood vessel blockage, this occurs 40% of the time
33
PV diagnosis
A unique feature of PV that is helpful in diagnosis is the development of intense, painful itching that appears to be intensified by heat or exposure to water (aquagenic pruritus), individuals avoid exposure to water, particularly warm water when bathing or showering
34
Secondary polycythemia
more common form essentially a physiologic response to hypoxia: usually due to increased erythropoietin production either in response to chronic hypoxia or from an erythropoietin secreting tumor (i.e. renal carcinoma, hepatoma, cerebellar hemangioblastomas)
35
Secondary polycythemia (patho)
Abnormal blood flow to kidneys can be perceived by the kidneys as decreased oxygen (renal hypoxia) even though other tissues may have normal oxygen
36
Secondary polycythemia (mani)
attributed to the underlying cause, such as chronic lung disease, than to polycythemia itself, shortness of breath, chronic cough, sleep apnea, dizziness, fatigue may also be common
37
Neutrophilia/ Granulocytosis
increase in granulocytes( neutrophils, eosinophils or basophils) is prevalent in the early stages of infection/ inflammation when stored neutrophils from venous sinuses are released into the circulating blood **count exceeds 7500/mm3
38
shift-to-the-left/ leukemoid reaction
premature release of the immature cells is responsible the early release of immature white cells prevents the completion of the sequence and shifts the distribution of leukocytes in the blood toward those on the left side
39
shift-to-the-right
as inflammation/infection diminishes and granulopoiesis replenishes circulating granulocytes **return to normal
40
Neutropenia
condition associated with the reduction in circulating neutrophils. exists clinically when the neutrophil count is less than 2000/mm3 Reduction in neutrophils occurs in severe prolonged infections when production of granulocytes cannot keep up with the demand if neutrophils are drastically reduced(
41
Infectious mononucleosis(IM)
an acute infection of B lymphocytes.( B cells) with Epstein-Barr virus(EBV) infections with EBV are common in children, particularly those from low socioeconomic environments
42
IM manifestations
classic group of symptoms: fever, sore throat, cervical lymph node enlargement and fatigue condition progresses, generalized lymph node enlargement may develop , also enlargement of of spleen to liver(25-75% indiv)
43
Leukemia
clonal malignant disorder of the blood and blood forming organs. **uncontrolled proliferation of malignant leukocytes, causing an overcrowding of bone marrow( pancytopenia) and decreased production and function of normal hematopoietic cells Normal granulocytic, monocytic, lymphocytic, erythrocytic and megakaryocytic progenitor cells cease to function
44
Acute Lymphocytic Leukemia (ALL)
Children
45
Chronic Lymphocytic Leukemia (CLL)
Adults
46
Acute Myelogenous Leukemia (AML)
Adults
47
Chronic Myelogenous Leukemia (CML)
Adults
48
Leukemia: anemia
decreased stem cell input or ineffective erythropoiesis or both
49
Leukemia: bleeding
reduction in megakaryocytes leading to thrombocytopenia
50
Leukemia: infection
Opportunistic organisms granulocytopenia or immune deficiency -> decreased protection secondary cause of chemotherapy, l corticosteroids, and disease process
51
Leukemia: weight loss
pain, depression, chemotherapy, radiation therapy, loss of appetite, and alteration in taste
52
Leukemia: bone pain
leukemic cells infiltrate bone or intramedullary infection
53
Leukemia: liver, spleen and lymph node enlargement
Leukemic cell infiltration; lymph nodes undergo leukemia proliferation in CLL
54
Leukemia: uric acid level elevation
increased catabolism of protein and nucleic acid urate precipitation increased from dehydration caused by anorexia or fever and drug therapy
55
Hodgkin (HL)
Characterized by the presence of Reed-Sternberg (RS) cells in the lymph nodes RS cells release cytokines -> infiltration and proliferation of inflammatory cells -> produce enlarged painless lymph node in the neck as well as local and systemic effects
56
Hodgkin (HL) (manifestations)
Enlarged, painless lymph node in neck (1st sign) mediastinal mass in chest - (asymptomatic - found in chest x-ray) Affects cervical, axillary, inguinal, and retroperitoneal lymph nodes
57
Lymphadenopathy
symptoms caused by pressure and obstruction from enlarged lymph nodes
58
Non-Hodgkin Lymphoma (NHL)
based on cell type: B, T, NK linked to chromosome translocations, viral and bacterial infections, environmental agents, immunodeficiencies, and autoimmune disorders
59
coagulation disorders
triggers of inappropriate coagulation, engaging the clotting factors and causing detrimental clotting w/in blood vessels
60
inherited coagulation disorders
hemophilia and von Willebrand disease
61
acquired coagulation disorders
tend to result from deficient synthesis of clotting factors by liver → liver disease and dietary deficiency of vitamin K
62
vasculitis
inflammation of blood vessels, along w/ vessel damage activates platelets, which activate coagulation cascade
63
DIC (disseminated intravascular coagulation)
acquired clinical syndrome characterized by widespread activation of coagulation, resulting in formation of fibrin clots in medium and small vessels throughout the body **characterized by a cycle of intravascular clotting followed by active bleeding caused by the initial consumption of coagulation factors and platelets and diffuse fibrinolysis
64
DIC (patho)
``` results from abnormally widespread and ongoing activation of clotting infectious disease (sepsis), is more common condition assoc. w/ DIC ```
65
DIC (mani)
Integumentary system: widespread hemorrhage and vascular lesions, oozing from puncture sites, incisions, mucous mbns., acrocyanosis (irregular-shaped cyanotic patches), gangrene CNS: subarachnoid hemorrhage, altered state of consciousness - slight confusion to convulsion and coma GI system: occult bleeding to massive GI bleeding, abdominal distention Pulmonary: ARDS, hypoxemia, etc. Renal: hematuria, oliguria, renal failure
66
Virchow triad
1. injury to blood vessel endothelium (atherosclerosis) 2. abnormalities of blood flow (major surgery, AMI, congestive heart failure, etc.) 3. hypercoagulability of blood (Factor V Leiden mutation; antiphospholipid syndrome (APS)

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