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Integrative Week Two > Heme/Immune > Flashcards

Flashcards in Heme/Immune Deck (67):
1

B12 def

neuro findings, high MCV

2

causes of B12 def

pernicious anemia (anti-IF Ab)
terminal ileitis
vegan

3

B12 def with normal B12

high homocysteine and methylmalonic acid

4

G6PD def

post sulfa drug hemolytic anemia

5

Hereditary Spherocytosis

mild anemia
high MCHC
splenomegaly
family history

6

Hyperhemolytic crisis

vaso-occlusion
splenic-sequestion
sickle cell patient profoundly anemic

7

Sickle Cell Complications

acute chest syndrome
salmonella osteomyelitis
avascular necoris of femoral head

8

Vaccines to give someone without spleen

pneumococcal
mening
Hib
(encapsulated)

9

TTP

fever, mental status changes
SCHISTOCYTES
renal dysfunction, low platelets

10

Cause of TTP

ADAM TS-13/vWF cleaving protease

11

CLL

older, massive LAD
spleen
WBC 30K with lymphs

12

CML

high WBC in all lines
mild illness
9:22/brc-abl translocation

13

CML treatment

imatinib

14

Acute promyelocytic leukemia

15:17 translocation
treat with all-trans-retinoic acid

15

Multiple Myeloma

anemia, renal failure, older
high Ca, high prot,albumin, narrow anion gap

16

Multiple Myeloma mechanism

osteoclast activating factors (Il-6)

17

ITP

post URI, normal WBC, HCT, platelets 5K
megakaroycytes on bone marrow biopsy

18

HUS

toxogenic E coli
child, bloody diarrhea than AKI
thrombocytopenia, anemia

19

Cis-platin/carboplatin

nephrotoxicity
acoustic nerve damage

20

Bleomycin/busulfan

pulmonary fibrosis

21

Vincristine

pierpheral neuropathy

22

Doxorubicin

cardiotoxicity

23

cyclophosphamide

hemorrhagic cystitis

24

Trastuzumab

mab against HER2, tyrosine kinase
CHF

25

Rituximab

ab against Cd-20
on most B cell neoplasms (NHL)

26

Omalizumab

anti-IgE
severe asthma

27

Bevacizumab

mab against VEGF
inhibits angiogenesis

28

Infliximab

anti TNF
crohn's, RA

29

Abciximab

anti-glycorotein IIb/IIIa
some acute coronary syndromes

30

Type I Hypersensitivity

preformed antibody
igE mediated
immediate symptoms

31

examples of Type I hypersensitivity

allergy
atopy
anaphylaxis

32

Type II Hypersensitvity

cytotoxic rxns of Abs against cells or tissus

33

Examples of Type II hypersensitvity

Hemolytic anemia - Coombs
Goodpastures - antiGBM

34

Type III Hypersensitvity

ag-ab complex deposition in tissue

35

Examples of Type III hypersensitvity

Vasculitis
Sle,RA
serum sickness, post strep GN, Arthus reaction

36

Arthus reaction

edema
necrosis
activation of complement

37

Type IV Hypersensitivity

T cell mediated
delayed presentation, 24-48 hrs

38

Examples of Type IV Hypersensitivity

TB skin test
contact dermatitis/poison ivy
GvH

39

tight skin on face, hands, pulmonary fibrosis, esophageal dysmotility, renal disease

scleroderma - systemic sclerosis
Anti-Scl-70/anti-DNA topoisomerase 1

40

proximal muscle weakness
elevated CK

polymyositis
Anti-Jo-1

41

Asthma, eosinophilia, necrotizing vasculitis

Churgg-Strauss
P-ANCA

42

Autoimmune hepatitis

40 year old women
acute, very high transaminases, +ANA
anti-smooth muscle antibodies

43

anti-smooth muscle Abs

autoimmune hepatitis

44

anti-liver/kidney/microsomal

autoimmune hepatitis in children

45

Primary Biliary Cirrhosis

middle aged women
high alk phosphatase
liver dz
anti-mitochondrial Abs

46

anti-mitochondrial Abs

PBC

47

celiac disease symptoms

diarrhea, steatorrhea, wt loss

48

celiac labs

anti-tissue transglutaminase (igA)
anti-endomysial

49

Celiac path

blunting of intestinal villi
crypt hyperplasia

50

Agammaglobulinemia

Xlinked/Burton's
infant boy, 4-6 months
encapsulated organism sepsis
absent B cells

51

Common Variable

young adult
recurrent sinusitis, pneumoa, bronchiectasis
splenomegaly, malignancies
GI malabsorption

52

Congential thymic dysplasia (Di George syndrome)

CHD/truncus arteriosus
hypoparathyroid
facial abnormalities
Low T cells

53

Recurrent Neiserria infections

terminal complment, C5-C9 deficiency

54

Chronic Granulomatous Disease

boy, chronic catalase + infections (Staph, Ecoli, Serratia, Aspergillus)
nitroblue terazolium

55

Chediak-Hegashi

AR chronic granulomatous disease

56

Oculocutaneous Albinism

chornic granulomatous Disease

57

Wiskott Aldrich

eczema, thrombocytopenia
X linked
combined B and T cell def

58

SCID

agammaglobulinemia
lymphopenia
infant

59

Cause of SCID

adenosine deaminase def
defected IL-2 receptors

60

Leukocyte adhesion def

infant
recurrent bacterial infections
persistent neutrophilia
absent pus
delayed separation of umbilical cord

61

transfusion
urticarial, pruritis, wheezing, fever

allergic rxn
type 1 hypersen
against plasma proteins in transfused blood

62

dyspnea, bronchospasm, hypotension, resp arrest, post tranfusion

anaphylactic rxn
IgA def patients get this from Abs to IgA after transfusion

63

fever, chills within 12 hours of transfusion
no hemolysis

febrile, nonhemolytic transfusion rxn
Type II, host antibodies veruse donor Ags and WBCs
(most blood banks remove WBCs now)

64

transfuion
fever, hypotension, flank pain, brown urine
immediate

acute hemolytic transfuion rxn
ABO mismatch

65

jaundice
slow hemolysis 1-2 weeks after transfusion

delayed hemolytic transfusion rxn
anti-Kell, Duffy
extravascular, previous exposure

66

shortness of air during transfusion
crackles

volume overload

67

fever, dyspnea, noncardiogenic pulmonary edema on CXR esp after FFP

transfusion associated acute lung injury