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HemeOnc Flashcards

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1
Q

CD14

A

Macrophage

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2
Q

Histaminase and arylsulfatase

A

Eosinophils

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3
Q

Hypersegmented neutrophil

A

B12/folate deficient

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4
Q

Heparin and histamine

A

Basophils, Mast cells

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5
Q

vWF receptor

Fibrinogen receptor

A

vWF: Gp1b

Fibrinogen: gpIIb/gpIIIa

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6
Q

CD34

A

Bone marrow stem cell

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7
Q

CD19/CD20

A

B cell

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8
Q

CD3/CD4

A

TH1/TH2

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9
Q

CD3/CD8

A

Cytotoxic t cell

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10
Q

Hemophilia A vs Hemophilia B

A

A- Factor VIII def

B - Factor IX def

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11
Q

Factors that vitamin K deficiency affects

A

II, VII, IX, X, protein C, protein S

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12
Q

Epoxide reductase

A

Reduces Vitamin K so it is active

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13
Q

Factors antithrombin inhibits

A

II, VII, IX, X, XI, XII

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14
Q

gpIb deficiency affects?

gpIIb/gpIIIa defiency affects?

A

gpIb - affects adhesion

gpIIb/gpIIIa - affects aggregation

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15
Q

Clopidogrel/Ticlopidine affect?

A

gpIIb/gpIIIa -> Decreased aggregation

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16
Q

Abciximab affects

A

gpIIb/gpIIIa

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17
Q

What affect do polycythemia and CHF have on ESR?

A

Decrease ESR

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18
Q

G6PD deficiency leads to what microsopic changes?

A

Heinz bodies, Bite cells

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19
Q

Asplenia leads to what microscopic change?

A

Howell Jolly bodies

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20
Q

What is the cause of hemolytic uremic syndrome?

A

E. coli O157:H57 from beef

Toxin damages endothelial cells -> leads to Hemolytic Uremic syndrome

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21
Q

Abnormal ristocetin test

And therapy

A

Looks at vWF disease

Therapy: Desmopressin will increase vWF release from Weibel Palade bodies in endothelial cells

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22
Q

What enzyme activates vitamin K? What acts on this enzyme to inhibit?

A

Vitamin K - Activated by epoxide reductase

K then gamma carboxylates to activate II, VII, IX, X, C, S

Inhibited epoxide reductase by warfarin

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23
Q

What do endothelial cells produce to decrease thrombosis?

A

PGI2

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24
Q

Function of thrombin

A

Converts fibrinogen to fibrin

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25
What does DIC affect?
Activates the coagulation cascade
26
What is the function of tPa?
Activates plasminogen to plasmin which breaks down fibrin clots and decreases clotting factors
27
How can fibrinolysis disorder be distinguished from DIC?
DIC - low platelet count, and increased D Dimers Fibrinolysis disorder -> Increased plasmin which affects fibrin and clotting factors but no change in platelets and no elevation of D dimers
28
How do endothelial cells prevent thrombosis?
Release tPa, which activates plasmin to cleave fibrin and clotting factors Prostacyclin (PGI2), and NO release heparin like molecules to increase antithrombin III
29
What effect does homocysteine have? What can cause an elevation in this?
endothelial damage is caused by elevated homocysteine Caused by decreased B12/folate levels -> Decreased homocysteine to methionine Or caused by decreased homocysteine to cystathionine
30
What hb levels define anemia in males and females?
Males < 13.5 Females < 12.5
31
Esophageal web, glossitis, beefy red tongue, iron def anemia
plummer vinson syndrome
32
People with thalassemia are protected against what?
Plasmodium falciparum malaria
33
What are the types of alpha thalassemia?
1 mutation - asymptomatic 2 mutations - cis: asian -> can pass to offspring trans: african Three genes: HbH formation Four genes: Hydrops fetalis and Hb Barts
34
What are the forms of B thalassemia to know?
Chromosome 11 (alpha thal is 16) B/B+: relatively minor, target cells seen and HbA2 increases (alpha2/delta2) B0/B0 -> increased HbF increased HbA2 Crewcut appearance, extramedullary hematopoiesis inc. risk of parvovirus B19
35
What population has increased risk of parvovirus B19 aplastic crisis?
B thalassemia major
36
B12 or folate deficiency leads to a buildup of what substance that damages endothelial cells leading to coagulation?
Homocysteine
37
Where is folate absorbed in the body?
Jejunum
38
Where and how is B12 absorbed?
Terminal ileum via intrinsic factor formed by gastric parietal cells
39
What lab finding is specific to Folate deficiency?
Normal methylmalonic acid
40
What step is impaired in B12 deficiency? What are the clinical findings?
B12 deficiency: Excess methylmalonic acid Dec. conversion of methylmalonic acid to succinyl coA CLinical findings: Spinal cord degeneration -> afects posterior column and lateral corticospinal tract
41
What is the first step that should be done in assessing a normocytic anemia?
Take the reticulocyte count and multiply by the hematocrit/45 >3% is good <3% means there is a problem making blood cells
42
How can extravascular vs intravascular normocytic anemias be distinguished?
Extravascular - Jaundice due to increased unconjugated bilirubin via protoporphyrin breakdown from Hb via splenic macrophages Intravascular normocytic anemia - Hemosidenuria due to increased hemoglobin breakdown and iron absorption in the renal tubules, and decreased haptoglobin which binds the hemoglobin in the blood from RBC breakdown
43
What causes spherocytosis?
Defect of cytoskeletal proteins
44
Osmotic fragility test
Hereditary spherocytosis
45
What biochemical substitution is found in sickle cell anemia?
Replace glutamic acid with valine
46
When is dactylytis seen? What about acute chest syndrome with vasoocclusion in pulmonary microcirculation?
Dactylytis - Children with sickle cell anemia Acute chest syndrome - Adults with sickle cell (similar to CHF)
47
What is the major complication of sickle cell TRAIT?
Eventual inability to concentrate urine as sickling occurs in renal medulla
48
What is the biochemical change in hemoglobin C?
Replacement with lysine (lyCine) and HbC crystals
49
What marker distinguishes immature left shift leukocytes?
Decreased CD16 Fc receptor
50
What cell line is increased in CML?
t(9:21) Basophils
51
What kind of cells undergo hyperplasia in infectious mononucleosis? Where are they located?
T cells Paracortex White pulp of spleen -> Periarterial lymphatic sheath
52
What initial screening test is done to check for EBV mononucleosis? What if it is negative? What secondary test is performed to confirm?
Monospot test Negative -> CMV Secondary test -> EBV viral capsid test
53
What do ALL cells have positive nuclear staining for?
Tdt -> DNA polymerase B cells - CD 10/19/20 T cells - CD2 to CD8!!! not CD10!!
54
What group is most at risk for ALL?
Down syndrome children AFTER the age of 5 years
55
What translocation is a marker for good prognosis in ALL? What is poor?
Good - t(12:21) Poor - t(9:22)
56
What is seen in AML in terms of cytoplasmic staining?
Auer rods MPO (myeloperoxidase)
57
What is the translocation in Acute Promyelocytic Leukemia?
t(15:17) retinoic acid
58
Down syndrome before age 5
acute megakaryoblastic leukemia
59
CD 5 CD 20 and smudge cells
CLL
60
TRAP with dry tap bone marrow w/ accumulation in red pulp of spleen Treatment?
Hairy cell leukemia 2-CDA -> adenosine deaminase inhibitor

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