hematology pp clues Flashcards
(159 cards)
1
Q
What is a Neutrophil? Function
A
The Phagocyte (has anti-microbials, most abundant)
2
Q
What is an Eosinophil?
A
The Parasite Destroyer, Allergy Inducer
3
Q
What is a Basophil?
A
The Allergy Helper (IgE receptor => histamine release)
4
Q
What is a Monocyte?
A
The Destroyer => MP (hydrolytic enzymes, coffee-bean nucleus)
5
Q
What is a Lymphocyte?
A
The Warrior => T, B, NK cells
6
Q
What is a Platelet?
A
The Clotter (no nuclei, smallest cells)
7
Q
What is a Blast?
A
Baby Hematopoietic cell
8
Q
What is a Band?
A
Baby Neutrophil
9
Q
What does high WBC and high PMNs tell you?
A
Stress demargination
10
Q
What does high WBC and <5% blasts tell you?
A
Leukemoid reaction, seen in burn pts (extreme demargination looks like leukemia)
11
Q
What does high WBC and >5% blasts tell you?
A
Leukemia
12
Q
What does high WBC and bands tell you?
A
Left shift => have infection
13
Q
What does high WBC and B cells tell you?
A
Bacterial infection
14
Q
What diseases have high eosinophils?
A
“NAACP”
Neoplasm (lymphoma)
Allergy/ Asthma
Addison’s disease (no cortisol → relative eosinophilia)
Collagen vascular disease Parasites
15
Q
What diseases have high monocytes (>15%)?
A
“STELS”
Syphilis: chancre, rash, warts
TB: hemoptysis, night sweats
EBV: teenager sick for a month
Listeria: baby who is sick
Salmonella: food
16
Q
What do high retics (>1%) tell you?
A
RBC being destroyed peripherally
17
Q
What do low retics tell you?
A
Bone marrow not working right (↓production)
18
Q
What is Poikilocytosis?
A
Different shapes
19
Q
What is Anisocytosis?
A
Different sizes
Either treating or healing from anemia
20
Q
What is the RBC lifespan?
A
120 days
21
Q
What is the platelet lifespan?
A
7 days
22
Q
What does –penia tell you?
A
Low levels (usually due to virus or drugs)
23
Q
What does –cytosis tell you?
A
High levels
24
Q
What does –cythemia tell you?
A
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 Myeloperoxidase deficiency cause?
Catalase + infections
28
What is Chediak Higashi? Can you say that real fast 3 times in a row?...
Lazy leukocyte syndrome: lysosomes are slow to fuse around bacteria
29
What organ can make RBCs if the long bones 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-DPG
* 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/ Fe3+
34
What is Acute Intermittent Porphyria?
↑Porphyrin, urine δ-ALA, porphobilinogen => abdominal pain, neuropathy, red urine
35
What is Porphyria Cutanea Tarda?
Sunlight => skin blisters w/
porphyrin deposits, Wood's
36
What is Erythrocytic Protoporphyria?
Porphyria cutanea tarda in a baby
37
What is Sickle cell disease?
Homozygous HbS: (βGlu6 →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?
(βGlu6→Lys), still charged =>no sickling
40
What is α-thalassemia?
1 deletion: Normal
2 deletions "trait": Microcytic anemia
3 deletions: Hemolytic anemia, Hb H=β4
4 deletions: Hydrops fetalis, Hb Bart=γ4
41
What is β-thalassemia?
1 deletion “β minor”: HbA2 and HbF
2 deletions "trait/intermedia/major":
only HbA2 and HbF => hypoxia at 6 mo
42
What is Cooley's anemia?
See w/ β thalassemia major (no 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) Hypercoaguable "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 (binds free floating
47
What is extravascular hemolysis?
RBC destroyed in spleen (problem w/ RBC membrane)=>splenomegaly
48
What enzymes need lead (Pb)?
* δ-ALA dehydratase
* 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 sausage digits?
Pseudo-hypoparathyroidism, psoriatic arthritis
53
What disease has 6 fingers?
Trisomy 13
54
What disease has 2-jointed thumbs?
Edwards and 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
* α-Thalassemia
* β-Thalassemia
* Pb poisoning
↑TIBC, menses, GI bleed, koilonychia
↓TIBC
↓δ-ALA synthase, blood transfusions AA,
Asians (Chr.16 deletion)
Mediterraneans (Chr.11 point mutation)
↓δ-ALA dehydratase,
↓ferrochelatase,
x- ray blue line, eating old paint chips
57
What are the Megaloblastic anemias?
* Vit B12 deficiency
* Folate deficiency
58
MCC Vit B12 deficiency
Tapeworms, vegans, type A gastritis, pernicious anemia
59
* Folate deficiency
overcooked food
glossitis
60
Alcohol
Fetal alcohol syndrome: smooth philthrum, stuff doesn't grow
61
What are the Intravascular Hemolytic anemias?
IgM
62
* G-6PD deficiency
Sulfa drugs, moth balls, fava beans, sudden drop in Hb
63
* Cold autoimmune
Mononucleosis, mycoplasma infections, RBC agglutination
64
What are the Extravascular Hemolytic anemias?
IgG
65
Spherocytosis
Defective spherin or ankyrin, + osmotic fragility test
66
* Warm autoimmune
Anti-Rh Ab, dapsone, PTU, anti- malarials, sulfa drugs
67
* Paroxysmal cold autoimmune
Bleeds after cold exposure, Donath- Landsteiner Ab
68
* Sickle cell anemia
Crew haircut x-ray, avascular necrosis of femur, painful toes and fingers
69
What are the Production Anemias?
* Diamond-Blackfan: No RBCs, 2-jointed thumbs
* Aplastic anemia: Pancytopenia, autoimmune, benzene, AZT, CAM, radiation
70
* Aplastic anemia:
Pancytopenia, autoimmune, benzene, AZT, CAM, radiation
71
What is Basophilic Stippling?
Lots of immature cells, ↑mRNA
(Pb poisoning)
72
What is a Bite cell = Basket cell?
Unstable Hb inclusions (G6-PD deficiency)
73
What is a Burr cell = Echinocyte?
Pyruvate kinase deficiency, Liver dz,
Post- splenectomy
74
What is Cabot's ring body?
Vit B12 deficiency, Pb poisoning
75
What is a Doehle body?
PMN leukocytosis (infection,
steroids, tumor)
76
What is a Drepanocyte?
Sickle cell anemia
77
What is a Helmet cell?
Fragmented RBC (Hemolysis: DIC,
HUS, TTP)
78
What is a Heinz body?
Hb precipitates and sticks to cell membranes (G-6PD
79
What is a Howell-Jolly body?
Spleen or bone marrow should have removed nuclei fragments (hemolytic anemia, spleen trauma, cancer)
80
What is a Pappenheimer body?
Fe ppt inside cell (sideroblastic anemia)
81
What is a Pencil cell = Cigar cell?
Fe deficiency anemia
82
What is Rouleaux formation?
Multiple myeloma
83
What is a Schistocyte?
Broken RBC (DIC, artificial heart valves)
84
What is a Sideroblast?
Macrophages pregnant w/Fe (genetic
or multiple transfusions)
85
What is a Spherocyte?
Old RBC
86
What is a Spur cell = Acanthocyte?
Lipid high in serum
87
What is a Stomatocyte?
Liver dz
88
What is a Target cell = Codocyte?
Less Hb (Thallasemias or Fe deficiency)
89
What is a Tear drop cell = Dacrocyte?
RBCs squeezed out of marrow (hemolytic anemia,bonemarrow
90
What is the Clotting Cascade?
How you stop bleeding
91
What are the Vitamin K clotting factors?
1 (0) 927
Protein C and Protein S
92
What do platelet problems cause?
Bleeding from skin and mucosa
93
What do clotting factor problems cause?
Bleeding into cavities
94
What causes increased PTT and bleeding time?
von Willebrand disease and Lupus
95
What is Bernard-Soulier?
Baby w/ bleeding from skin and mucosa, big platelets (low GP1b)
96
What is Glanzmann’s?
baby w/ bleeding from skin and
mucosa (low GP2b3a)
97
How does Factor 13 deficiency present?
Umbilical stump bleeding (1st time baby has to stabilize a clot)
98
What is Factor V Leiden?
Protein C can't break down Factor 5
=> more clots
99
How does von Willebrand Disease present?
Heavy menstrual bleeding
100
What are the types of VWD?
Type 1 (AD): ↓VWF production
Type 2 (AD): ↓VWF activity (+ Ristocetin aggregation test)
Type 3 (AR): No VWF
101
What is Hemophilia A?
Defective Factor 8 (< 40% activity) => bleed into cavities (head, abdomen, etc.)
102
What is Hemophilia B?
Factor 9 deficiency => bleed into joints (knee, etc.)
103
What diseases have low LAP?
CML, PNH
104
What has high LAP?
Leukemoid reaction
105
What is the difference between acute and chronic leukemias?
Acute: started in bone marrow, squeezes RBC out of marrow Chronic: started in periphery, not constrained => will expand
106
What is the difference between myeloid and lymphoid leukemias?
Myeloid: ↑RBC, WBC, platelets, MP (↓lymphoid cells) => bone marrow biopsy Lymphoid: ↑NK, T, B cells (↓myeloid cells) => do lymph node
107
What defines ALL?
<15y/o males, bone pain, PAS stain
+, TdT +
108
What defines AML?
15-30y/o males, Sudan Stain, Auer rods
109
What defines CML?
30-50y/o females, t(9,22) "Philadelphia chromosome", bcr-abl, ↓LAP
110
What defines CLL?
>50 y/o males w/ lymphadenopathy, "soccer ball" nuclei, smudge cells
111
What defines Hodgkin's lymphoma?
EBV, may have Reed-Sternberg cells
112
What are the B cell Non- Hodgkin's lymphomas?
Follicular: t(14,18), bcl-2
Burkitt: t(8,14), c-myc, starry sky MP
* American kids: abdominal mass
* African kids: jaw mass
113
What are the T cell Non- Hodgkin's lymphomas?
Mycosis fungoides: total body rash
Sezary syndrome: cerebriform
114
What is Polycythemia Vera?
Hct >60%, ↓Epo, Budd-Chiari,
plethoric "pruritis after bathing"
115
What is Essential Thrombocythemia?
Very high platelets, stainable Fe, ↓c-mpl
116
What is Myelofibrosis?
Megakaryocytes, fibrotic marrow => teardrop cells, extramedular hematopoiesis
117
What are plasma cytomas?
Produce lots of Ab
118
What is Waldenstrom Macroglobulinemia?
IgM, hyperviscous
119
What is Monoclonal Gammopathy of Undetermined Significance?
Old person w/ gamma spike
120
What is Multiple Myeloma?
Serum M prot (IgG), urine Bence- Jones protein, rouleaux, punched-out lesions
121
What is Heavy Chain Disease?
↑IgA, infiltration of bowel wall
122
What is Histocytosis X?
Kid w/ eczema, skull lesions, diabetes insipidus, exopthalmos
123
What does the Coombs test tell you?
Ab involved against RBC
124
What does the direct Coombs test tell you?
On surface => hemolytic anemias
125
What does the indirect Coombs test tell you?
In serum
126
What is type and cross?
You know you can use that blood, save it for specific pt
127
What is type and match?
Type it and wait
128
What is forward typing?
Uses Ab to detect Ag "Fabulous"
129
What is backward typing?
Uses Ag to detect Ab
130
What does blood type A tell you?
Have the A antigen
131
What does blood type O tell you?
Have no antigens, universal donor
132
What does blood type AB tell you?
Have both antigens, universal recipient
133
What does Rh + tell you?
Has D antigen
134
What does Rh – tell you?
Does not have D antigen
135
hemolytic disease of the newborn?
Rh – Mom's placenta tears, 100cc baby's blood sees Mom/produces Ab, attacks fetus
136
What is RHOGAM?
Anti-D IgG
137
When do you give RHOGAM?
1st Dose: after delivery of 1st baby
2nd Dose: week 28 of any subsequent pregnancy
138
What is the most common transplant?
Blood
139
What is a Syngenic transplant?
Twin to twin
140
What is an Autograft?
Self-to-self transplant
141
What is an Allograft?
Human-to-human transplant
142
What is a Xenograft?
1 species to another species
143
What is Hyperacute rejection?
Within 12 hrs (preformed Ab)
144
What is Acute rejection?
4 days to years later (T-cells, MP)
145
What is Chronic rejection?
> 7 days (Fibroblasts)
146
What is Graft vs. Host disease?
Bone marrow transplants reject (TK, MP)
147
What are Immunoprivileged sites?
No lymphatic flow => no Ag => easy to transplant (brain, cornea, thymus, testes)
148
What is INR?
Measured PT/ Control PT
149
Lymphoma:scanty cytoplasm n irregular, twisted, indented nuclei
T(18:14) follicular B-cell lymphoma
IGH locus (14) and BCL2(18)
150
MCC of every ‘penia is
Viral infection
Drugs
151
Migration through the endothelium is via
P-CAM
152
CD-18
INTEGRIN are seen during
Pavementing
153
Leukocytosis dt stress demargination WBC/NEUROPHILS
WBC up
Neutrophils up
154
Leukocytosis dt infection: bands
Up
Left shift: kills germs
155
Leukomoid reaction: blast level
Below 5%
Low T cell and eosinophils
156
Leukemia blast level
>5%
157
Cancer is more common in women b/t
30-50 yo
158
PAS (+), TDT, Calla pos
ALL
Calla mean good response to chemo
159
AML LAB
Auer Rod
Sudan Black
T(15/17)
