Flashcards in Hematology Deck (88):
What does high WBC and High PMN's tell you?
Stress demargination. (Stress response - post trauma)
What does a high WBC and <5% Blasts tell you?
Leukemoid reaction - seen in burn patients or any extreme stress
(extreme demargination looks like Leukemia), Metamyelocytes => Myelocytes
What does high WBC and Bands tell you?
Left shift - they have an infection
What does high WBC and >5% Blasts tell you?
What does high WBC and B Cells tell you?
What diseases have high eosinophils?
N - Neoplasm (Lymphoma)
A - Allergy/ Asthma
A - Addison's disease (no cortisol -relative eosinophilia)
C - Collagen Vascular disease (lupus)
P - Parasites
What diseases have high Monocytes (>15%)?
Syphilis: chancre, rash, warts
TB: Hemoptysis, night sweats
EBV: Teen sick for a month
Listeria: Sick baby
Salmonella: Food poisoning
What do high Retics (>1%) tell you?
RBC is being destroyed peripherally
What do low reticulocytes tell you?
Decreased production of bone marrow - not working right
What is Poikilocytosis?
RBC's of different shapes
What is Anisocytosis?
RBC's with different sizes
What is the RBC normal lifespan?
What is the RBC lifespan when there is a problem?
60-90 days (same time as the shelf life of blood bank units)
What is the Platelet lifespan?
What does "Penia" tell you?
Low Levels - (Usually due to virus or drugs)
What does "Cytosis" tell you?
What does "Cythemia" tell you?
What is the difference between Plasma and Serum?
Plasma: No RBC's
Serum: No RBC's or Fibrinogen
What are the Microcytic Hypochromic Anemias?
Defect in Hb synthesis (RBC small and pale) "FAST lead"
F - Fe Deficiency
A - Anemia of Chronic Disease
S - Sideroblastic Anemia
T - Alpha and Beta Thalassemia's
L - Lead poisoning
What will you see with Iron Deficiency Anemia?
Increased TIBC(total iron binding capacity) associated with menses, GI bleeding, and Koilonychia (spooning of nails)
What will you see with Anemia of Chronic Disease?
Decreased TIBC (total iron binding capacity)
What will you see with Sideroblastic Anemia?
Decreased dALA synthase common with blood transfusions
What will you see with Alpha Thalassemia?
Seen in African Americans and Asian Americans (Chromosome 16- deletion)
What will you see in Beta Thalassemia?
Seen in Mediterranean's
(chromosome 122- point mutation)
What will you see in Lead Poisoning?
Decreased dALA dehydrogenase
blue lines on x-ray
history of eating old paint chips
What are the Megaloblastic Anemias?
Vitamin B-12 Deficiency
What are some causes of Vitamine B12 deficiency?
Type A gastritis
What are some causes of Folate Deficiency?
Old food, you will see Glossitis(inflammation of tongue) with the patient
What is the effect of Alcohol on the fetus?
FAS (Fetal Alcohol Syndrome)
Smooth philtrum (space between nose- mouth, normal people have dimple)
thin superior Vermilion border
What are the Intravascular Hemolytic Anemias?
IgM G6PD deficiency
What are some causes of G6PD Deficiency?
Sulfa drugs, mothballs, fava beans, sudden drop in Hb
What are some causes of Cold Autoimmune?
Antibody (IgM) bind to RBC's membrane
cold temp and causes agglutination
What are the Extravascular Hemolytic anemias?
Paroxysmal cold autoimmune
Sickle cell anemia
What is seen in Spherocytosis?
Defective Spherin or Ankyrin
Positive Osmotic Fragility test
High level of MCHC (Mean corpuscular hemoglobin concentration)
What is seen in Warm Autoimmune?
Anti-Rh Ab Dapsone, PTU, antimalarials, and sulfa drugs
Antibody (IgG) binds to RBC's membrane in warm temp
What is seen in Paroxysmal Cold Auto Autoimmune?
Bleeds after cold exposure Donath-Landsteiner Ab
What is seen in Sickle Cell Anemia?
Crew-cut on x-ray
Avascular Necrosis of femur
What are the Production Anemias?
What is seen in Diamond-Blackfan Anemia?
They have low RBCs and double jointed thumbs
What is seen / causes in Aplastic Anemia?
AZT (Zidovudine an HIV antiviral drug)
Chloramphenicol (Ricketsia bacterial infections)
What is Basophilic Stippling?
Lots of immature cells increased mRNA (seen in lead poisoning)
What is a Bite Cell?
Unstable Hb inclusions (seen in G6PD Deficiency)
What are Burr Cell/ Echinocyte?
Seen in Pyruvate Kinase deficiency
What is Cabot's Ring body?
Seen in Vitamin B12 Deficiency and lead poisoning
What is a Dohle Body?
PMN Leukocytosis (polymorphonuclear neutrophils, also called granulocytes)
(caused by infections, steroids, tumor)
What is a Drepanocyte?
Seen in Sickle cell Anemia
What is a Heinz body?
Seen when Hb precipitates and sticks to cell membranes in G6PD deficiency
What is a Howell-Jolly Body?
The spleen or bone marrow should have removed nuclei fragments.
(Seen in Hemolytic Anemia, spleen trauma, and CA)
What is a Pappenheimer body?
Iron inside cell (sideroblastic anemia)
What are Pencil Cell/ Cigar Cell?
Seen in iron deficiency anemia
What is Rouleaux formation?
Seen in Multiple Myeloma (Stacked coin look)
What is a Schistocyte?
Broken RBC (seen in DIC and artificial heart vlaves and others)
What is a Sideroblast?
Macrophages pregnant with Iron (caused by genetics and or multiple transfusions)
What is a Spherocyte?
What are Spur Cells / Acanthocytes?
Lipid bilayer disease
What is a Stomatocyte?
Seen in liver disease
What is a Target Cell/ Codocyte?
These have less Hb (seen in Thalassemias or iron deficiency)
What is a Tear Drop Cell/ Dacrocyte?
RBC's squeezed out of bone marrow. (Seen in Hemolytic Anemia and bone marrow CA)
What do Platelet problems cause?
Bleeding from skin and mucosa
What do Clotting problems cause?
Bleeding into cavities
What causes increased PTT and Bleeding Time?
Von Willebrand disease and SLE
What is Bernard-Soulier?
Baby with bleeding from skin and mucosa
(Big platelets and LOW GP-1b)
What is Glanzmann's?
Baby with bleeding from skin and mucosa (LOW GP-2b3a)
How does Factor 13 Deficiency present?
Umbilical stump bleeding
(this is the first time a baby has to stabalize a clot)
What is a Factor V - Leiden?
Protein C cannot break down Factor V
How does Von Willebrand Disease (VWD) present?
Heavy menstrual bleeding
What are the types of VWD?
Type 1 (AD): Decreased VW FActor Production
Type 2 (AD): Decreased VW Activity
(+ Ristocetin Aggregation test)
Type 3 (AR): No VWF
What is Hemophilia A?
Defective Factor VIII (<40% Activity)
Bleed into cavities (head, abdomen, etc)
What is Hemophilia B?
Factor IX deficiency
Bleed into joints (knee, etc)
What is Polycythemia Vera?
Hematocrit (Hct) >60% Decreased EPO, Budd-Chiari
Pruritis after bathing
What is Essential Thrombocythemia?
Very high platelets increased RBC's and WBC's
What is Histiocytosis X?
Kid with Eczema, skill lesions
What does the Coombs Test Tell you?
What does the Direct Coombs Test tell you?
Antibody on surface (seen in hemolytic anemia)
What does Indirect Coombs Test tell you?
The Antibody is freely circulating in the serum
What is Type and Cross?
Blood that is matched by blood type and cross-reacted with the patient's blood for rejection
What is Type and Match?
Blood type and Wait
What is Forward Typing?
Uses Antibodies to detect Antigens
What is Backward Typing?
Used Antigens to detect Antibodies
What does blood type A tell you?
They have the A antigen and B antibodies
What does blood type O tell you?
They have no antigens (Universal donor)
What does blood type AB tell you?
Have both Antigens (universal recipient)
What does Rh+ tell you?
Has D Antigen
What does Rh- tell you?
Does not have the D Antigen
What is Hemolytic Disease of the Newborn?
Rh+ mom's blood mixes the Rh- fetal blood in first pregnancy
No risk to this child
All pregnancies to follow will be a risk, leading to a fetal demise
What is RhoGam?
When do you give RhoGam?
1st Dose: Week 28 gestation
2nd Dose: 72 hours post-delivery
Any time a procedure would mix mom and fetal blood