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PP Hematology Flashcards

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0
Q

What is an Eosinophil?

A

The Parasite Destroyer

Allergy Inducer

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1
Q

What is a neutrophil?

A

The Phagocyte (has anti-microbials, most abundant)

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2
Q

What is a Basophils?

A

The Allergy Helper ( IgE receptor => histamine release)

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3
Q

What is a Monocyte?

A

The Destroyer => MP (hydrolytic enzyme, coffee-bean nucleus)

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4
Q

What is a Lymphocyte?

A

The Warrior => T, B, NK cells

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5
Q

What is a Platelet?

A

The Clotter ( no nuclei, smallest cells)

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6
Q

What is a Blast?

A

Baby Hematopoietic cell

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7
Q

What is a Band?

A

Baby Neutrophil

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8
Q

What does high WBC and high PMNs tell you?

A

Stress Demargination

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9
Q

What does high WBC < 5% blast tell you?

A

Leukemoid reaction

Seen in burn pts ( extreme demargination looks like leukemia)

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10
Q

What does high WBC and >5% blast tell you?

A

Leukemia

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11
Q

What’s does high WBC and bands tell you?

A

Left shift => have infection

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12
Q

What does high WBC and B cell tell you?

A

Bacterial infection

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13
Q

What diseases have high eosinophils?

A

“NAACP”

  • Neoplasm (lymphoma)
  • Allergy/ Asthma
  • Addison’s disease (no cortisol -> relative eosinophilia)
  • Collagen vascular disease
  • Parasites
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14
Q

What disease 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 poisoning
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15
Q

What do high retics (>1%) tell you?

A

RBC being destroyed peripherally

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16
Q

What do low retics tell you?

A

Bone marrow not working right (decrease production)

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17
Q

What is Poikilocytosis?

A

Different shapes

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18
Q

What is Anisocytosis?

A

Different size

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19
Q

What is the RBC lifespan?

A

120days

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20
Q

What is the platelets lifespan?

A

7days

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21
Q

What does -penia tell you?

A

Low levels ( usually due to virus or drugs)

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22
Q

What does -cytosis tell you?

A

High levels

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23
Q

What does -cythemia tell you?

A

High levels

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24
What is the difference between plasma and serum?
Plasma: no RBC Serum: no RBC or fibrinogen
25
What is Chronic Granulomatous Disease?
NADPH oxidase deficiency -> recurrent | Staph/Aspergillus infections ( nitroblue tetrazolium stain negative)
26
What does MPO deficiency cause?
Catalase + infections
27
What is Chediak Higashi?
Lazy lysosomes syndrome: lysosomes are slow to fuse around bacteria
28
What organ can make RBCs if the long bones are damaged?
Spleen=> splenomegaly
29
What causes a shift to the right in the Hb curve?
"All CADETs face right" - Increase CO2 - Acid/Altitude - 2,3 -DPG - Exercise - Temp
30
How does CO poison Hb?
Competitive inhibidor of O2 on Hb => cherry-red lips, pinkish skin hue
31
How does Cyanide poison Hb?
Non-competitive inhibitor of O2 on Hb => almond breath
32
What is MetHb?
Hb w/ Fe+3
33
What is Acute Intermittent Porphyria?
Defected enzyme: Porphobilinogen deaminase Accumulation of: Prophobilinogen, delta ALA, uroporphyrin Symptoms: Painfull abdomen, Port wine ( colored urine), Prolyneuropathy, Psychological disturbances, Precipitated by drugs
34
What is Porphyria Cutanea Tarda?
Defected enzyme: Uroporphyrinogen decarboxylase Accumulation of: uroporphyrin ( tea color urin) Symptoms: blistering cutaneous photosensitivity
35
What is Erythrocytic Protoporphyria?
Porphyria cutanea tarde in a baby
36
What is Sickle cell disease?
Homozygous HbS: ( Glu -> Val ) => vaso occlusion, necrosis, dactylitis (painful finger/ toes) at 6 month,
37
What is Sickle cell trait?
Heterozygous HbS => painless hematuria, sickle with extreme hypoxia, have resistance to malaria
38
What is Hb C disease?
Glu -> Lys | Still charged => no sickling
39
What is Alfa -thalassemia?
- 1deletion: normal - 2 deletion " trait": Microcytic anemia - 3 deletion: Hemolytic anemia, Hb H= B4 - 4 deletion: Hydrops fetalis, Hb Bart= y4
40
What is beta-thalassemia?
- 1deletion "B minor" : increase HbA2 and HbF - 2 deletions " trait /intermedia/ major": only HbA2 and HbF => hypoxia at 6 month
41
What is Cooley's anemia?
See w/ beta thalassemia major ( no HbA => excess RBC production) Baby making blood from everywhere => frontal bossing, hepatosplenomegaly, long extremities
42
What is Virchow's triad?
Thrombosis risk factors: 1. Turbulent blood flow " slow" 2. Hypercoagulable "sticky" 3. Vessel wall damage
43
What does acute hypoxia causes?
Shortness of breath
44
What does chronic hypoxia causes?
Clubbing of fingers/toes
45
What is intravascular hemolysis?
RBC destroyed in blood v. -> low haptoglobin ( binds free floating Hb)
46
What is extravascular hemolysis?
RBC destroyed in spleen (problem with RBC membrane) => splenomegaly
47
What enzymes need lead (Pb)?
Delta-ALA dehydrase | Ferrochelatase
48
What does EDTA bind?
X2+
49
What disease has a smooth philthrum?
Fetal alcohol syndrome
50
What disease has a long philthrum?
Williams
51
What disease has sausage digits?
Pseudo-hypoparathyroidism | Psoriatic arthritis
52
What disease has 6 fingers?
Trisonomy 13
53
What disease has 2-jointed thumbs?
Diamond-Blackfan
54
What disease has painful fingers?
Sickle cell disease
55
What are the Microcytic Hypochromic anemias?
"FAST Lead" - Fe deficiency ( increase TIBC, GI bleed, koilonychia) - Anemia of chronic disease ( decrease TIBC) - Sideroblastic anemia ( decrease delta-ALA synthase, blood transfusion) - Alfa Thalassemia ( AA, Asian (chr. 16 deletion) - beta Thalassemia (Mediterranean ( chr. 11 point mutation)) - Pb poisoning ( decrease delta-ALA dehydrogenase, decrease ferrochelatase, x-ray blue line, eating old paint chips)
56
What are the Megaloblastic anemias?
- vit. B12 deficiency - Folate deficiency - Orotic Aciduria
57
What are the Intravascular Hemolytic anemia?
PNH | Autoimmune hemolytic anemia
58
What are the Exatravascular Hemolytic anemia?
``` Hereditary spherocytosis G6PD defi PK defi Sickle cell disease HbC ```
59
What are the Production Anemias?
- Diamond-Blackfan: no RBCs, 2-jointed thumbs - Aplastic anemia: Pancytopenia, autoimmune, benzene, AZT, CAM, radiation
60
What is Basophilic Stippling?
``` Lots of immature cells Increase mRNA ( Pb poisoning) ```
61
What is a Bite cell = Basket cell?
Unstable Hb inclusion (G6-PD deficiency)
62
What is a Burr cell = echinocyte?
Pyruvate kinase deficiency Liver dz Post-splenectomy
63
What is Cabot's ring body?
Vit B12 defi | Pb poisoning
64
What is a Doehle body?
PMN leukocytosis ( infection, steroids, tumors)
65
What is a Drepanocyte?
Sickle cell anemia
66
What is a Helmet cell?
Fragmented RBC ( hemolysis: DIC, HUS, TTP)
67
What is Heinz body?
Hb presipitates and sticks to cell mm (G-6PD deficiency)
68
What is a Howell-Jolly body?
Spleen or bone marrow should have removed nuclei fragment ( hemolytic anemia, spleen trauma, cancer)
69
What is a Pappenheimer body?
Fe ppt inside cell ( Sideroblastic amenia)
70
What is a Pencil cell = cigar cell?
Fe deficiency anemia
71
What is a Roleaux formation?
Multiple myeloma
72
What is Schistocyte?
Broken RBC ( DIC, artificial heart valves)
73
What is a Sideroblast?
Macrophages pregnant w/Fe (genetic or multiple transfusion)
74
What is a Spherocyte?
Old RBC
75
What is a Spur cell = Acanthocyet?
Lipid bilayel dz.
76
What is Stomatocyte?
Liver dz
77
What is a Target cell = Codocyte?
Less Hb ( Thalassemia or Fe defi)
78
What is Tear drop cell = Dacrocyte?
RBCs squeezed out of marrow ( hemolytic anemia, bone marrow cancer)
79
What is the Clotting Cascade?
How you stop bleeding
80
What do platelet problem cause?
Bleeding from skin and mucosa
81
What do clotting problems cause?
Bleeding into cavities
82
What causes increased PTT and bleeding time?
von Willebrand disease and Lupus
83
What is Bernard-Soulier?
``` Baby w/ bleeding from skin and mucosa Big platelet ( low GP1b) ```
84
What is Glanzmanns ?
Baby w/ bleeding from skin and mucosa ( low GP2b3a)
85
How does Factor 13 deficiency present?
Umbilical stump bleeding ( 1st time baby has to stabilize a clot)
86
What is Factor V Leiden?
Protein c can't breack down Factor 5 => more clots
87
How does Von Willebrand Disease present?
Heavy menstrual bleeding
88
What are the type of VWD?
Type1 (AD): decrease VWF production Type2 (AD): decrease VWF activity Type3 (AR): no VWF
89
What is Hemophylia A?
Defective factor 8 ( < 40% activity) => bleed into cavities
90
What is Hemophilia B?
Factor 9 deficiency => bleed into joint
91
What disease have low LAP?
CML | PNH
92
What has high LAP?
Leukemoid reaction
93
What is the deference between acute and chronic leukemia?
``` Acute: - starts in bone marrow - squeezes RBC out of marrow Chronic: - starts in periphery - not constrained => will expand ```
94
What is the difference between myeloid and lymphoid leukemia?
``` Myeloid: - increase RBC, WBC, platelets, MP - bone marrow biopsy Lymphoid: - increase NK, T, B cells - do lymph node biopsy ```
95
What defines ALL?
< 15 y / o males Bone pain PAS stain + TdT +
96
What defines AML?
15-30 y/o males Sudan stain Auer rods
97
What defines CML?
30-50 y/o females t(9,22) " Philadelphia chromosome" bcr-abl Decrease ALP
98
What defines CLL?
>50 y/o males w/ lymphadenopathy "Soccer ball" nuclei Smudge cells
99
What defines Hodgkin's lymphoma?
EBV | May have Reed-Sternberg cells
100
What are the B cell Non-Hodgkin's lymphoma?
Follicular: t(14:18), bcl-2 Burkitt: t(8:14), c-myc, starry sky MP - American kids: abdominal mass - African kids: jaw mass
101
What are the T cells Non-Hodgkin's lymphoma?
Mycosis Fungoides: total body rash | Sezary Syndrome: cerebreform cells
102
What is Polycythemia Ruba Vera?
Hct > 60% Decrease Epo Budd-Chiari Plethora " pruritis after bathing"
103
What is Essential Thrombocytopenia?
Very high platelets Stainable Fe Decrease c-mpl
104
What is Myelofibrosis?
Megakaryocytes | Fibrotic marrow => teardrop cells, extramedular hematopoiesis
105
What are plasma neoplasms?
Produce lots of Ab
106
What is Waldenstrom Macroglobulinemia?
IgM | Hypervicous
107
What is Monoclonal Gammopathy?
Old person 2w/ gamma spike
108
What is Mùltiple Myeloma?
Serum M prot ( IgG) Urine Bencen-Jones protein Rouleaux Punched-out lesion
109
What is heavy chain disease?
Increase IgA
110
What is Histocytisis X?
Kids w / eczema Skull lesions Diabetes Insipidus Exophthalmos
111
What does the Coombs test tell you?
Ab involved
112
What does the direct Coombs test tell you?
On surface => hemolytic anemia
113
What does an indirect Coombs test tell you?
In serum
114
What is type and cross?
You know you can use that blood | Save it for specific pts
115
What is type and match?
Type it and wait
116
What is forward typing?
Uses Ab to detect Ag "Fab"
117
What is backward typing?
Uses Ag to detect Ab
118
What does Type A blood tell you?
Have the A antigen
119
What does blood Type O tell you?
Have no antigen | Universal donor
120
What does blood Type AB tell you?
Have both antigen | Universal recipent
121
What does Rh + tell you?
Has D antigen
122
What does Rh - tell you?
Does not have the D antigen
123
What is Hemolytic Disease of the Newborn?
Rh- moms placenta tears 100cc baby's blood sees Moms produce Ab Attacks fetus
124
What is RHOGAM?
Anti-D IgG
125
When do you give RHOGAM?
1st dose: 28wk gestation ( of 2nd child) | 2nd dose: 72h post delivery ( Rh+ baby)
126
What is the most common transplant?
Blood
127
What is a Syngenic transplant?
Twin to twin
128
What is an Autograft?
Self to self transplant
129
What is an Allograflt?
Human to human transplant
130
What is Xenograft?
1 species to another species
131
What is Hyperacute rejection?
Within 12h ( preformed Ab)
132
What is Acute rejection?
4 days to years laters ( T-cells, MP)
133
What is Chronic rejection?
>7 days (fibroblast)
134
What is Graft vs. Host disease?
Bone marrow transplant reject
135
What are immunoprivileged sites?
No lymphatic flow => no Ag => easy to transplant ( brain, cornea, thymus, testes)
136
What is INR?
Measured PT / control PT
137
What pathology are associated with Acanthocyte?
Liver disease | Abetalipoproteinemia
138
What pathology are associated with Basophilic stippling?
Thalassemia Anemia of chronic disease Lead poisoning
139
What pathology are associated with Bite cell?
G6PD deficiency
140
What pathology are associated with Ringed sideroblasts?
Sideroblastic anemia
141
What pathology are associated with Schistocyte, Helmet cell?
DIC TTP/ HUS Traumatic hemolysis
142
What pathology are associated with sickle cell?
Sickle cell anemia
143
What pathology are associated with Spherocyte?
Hereditary spherocytosis | Autoimmune hemolysis
144
What pathology are associated with Teardrop cell?
Bone marrow infiltration
145
What pathology are associated with Target cell?
HbC disease Asplenia Liver disease Thalassemia
146
What pathology are associated with Heinz bodies?
G6PD deficiency
147
What pathology are associated with Howell-Jolly bodies?
Functional hyposplenia or asplenia

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