Quiz 3 Flashcards
(156 cards)
1
Q
Formation of blood cellular components
A
hematopoiesis
pg 4
2
Q
Where does hematopoiesis occur in children?
A
tibia and femur
pg 4
3
Q
Where does hematopoiesis occur in adults?
A
pelvis, cranium, vertebral bodies, sternum, ribs
pg 4
4
Q
Formation of blood cellular components outside of the medullary cavity
A
extramedullary hematopoiesis
pg 4
5
Q
Where does extramedullary hematopoiesis occur?
A
spleen, liver, lymph nodes, thymus
pg 4
6
Q
Categories of Anemia
A
1) blood loss
2) increased RBC destruction
3) decreased RBC production
pg 8
7
Q
Effects of hypoxia from anemia
A
increased erythropoietin from kidneys, pallor, fatigue, weakness
pg 9
8
Q
Anemia due to trauma, GI or gynecologic issues
A
anemia of blood loss
pg 10
9
Q
Anemia of blood loss is ____(hypo, normo, or hyper -chromic/cytic)
A
normocytic/normochromic
pg 10
10
Q
Anemia of blood loss may lead to ____ shock
A
hypovolemic shock
pg 10
11
Q
Anemia due to the decreased life span of RBC
A
hemolytic anemia
pg 11
12
Q
Decreased life span of RBC
A
hemolysis
pg 11
13
Q
2 types of defects resulting in hemolytic anemia
A
intracorpuscular defects
extracorpuscular defects
pg 11
14
Q
Hereditary defect resulting in hemolytic anemia
A
intracorpuscular defect
(abnormal membranes or disordered Hb synthesis)
pg 11
15
Q
Acquired defect resulting in hemolytic anemia
A
extracorpuscular defect
(RBC trauma, infections, antibodies)
pg 11
16
Q
Where does intravascular hemolysis occur?
A
peripheral circulation
pg 12
17
Q
Where does extravascular hemolysis occur?
A
liver and spleen
pg 12
18
Q
Increased Hb in urine
A
hemoglobinuria
pg 12
19
Q
Components of intravascular hemolysis
A
damaged heart valve, toxins or heat; hemoglobinuria; jaundice and gallstones
pg 12
20
Q
Components of extravascular hemolysis
A
RBC damage, antibody opsonization; splenomegaly
pg 12
21
Q
Which is more common, extravascular or intravascular hemolysis?
A
extravascular hemolysis
pg 12
22
Q
Clinical term for gallstones
A
cholelithiasis
pg 14
23
Q
% of population affected by cholelithiasis?
A
10-20%
pg 15
24
Q
Cholelithiasis are more commonly ____(asymptomatic or symptomatic)
A
asymptomatic 80%
pg 15
25
Which is more common: cholesterol stones or pigmented stones?
cholesterol stones
| pg 15
26
Risk factors for cholelithiasis
family history, obesity, diabetes, hemolytic anemia, estrogen
pg 16
27
Abnormally shaped RBCs
poikilocyte
| pg 17
28
Irregularly shaped RBCs, from hemolysis
schistocyte
| pg 17
29
Teardrop shaped RBCs
dacrocyte
| pg 17
30
RBC membrane defect(autosomal dominant)
hereditary spherocytosis
| pg 21
31
Hereditary Spherocytosis may result in ____ ____ which may be made worse by the presence of parvovirus B19
aplastic crisis
inability to make RBCs
pg 21
32
Beta-globin mutation(autosomal recessive)
sickle cell anemia
| pg 24
33
Sickle cell trait is ____zygous
heterozygous
| pg 24
34
Sickle cell anemia/disease is ____zygous
homozygous
| pg 24
35
Sickle cell trait effects what % of African Americans?
8%
| pg 24
36
In what areas do RBCs sickle in those with sickle cell anemia?
sites of blood stasis; bone marrow(MC), spleen, site of infection or inflammation, and/or during dehydration
pg 25
37
Which has a worse prognoses; heterozygous or homozygous sickle cell?
homozygous; 50% survive beyond 5th decade
| pg 27
38
Lethal results of sickle cell anemia
1) acute chest syndrome
2) stroke
pg 27
39
Effects of sickle cell anemia
thrombosis, fever, malaise, chronic low-level pain, splenomegaly/infarction, gallstones, priapism, stunted growth, osseous distortion
pg 28
40
Possible H-shaped vertebra are characteristic of which disease?
Sickle cell anemia (10% of patients)
| pg 31
41
Hemoglobinopathy of mutated alpha or beta-globin genes
Thalassemia
| pg 33
42
Hemoglobinopathy decreasing beta-globin chains
Beta-thalassemia
| ph 34
43
Beta-thalassemia with 1 allele mutation
minor
| pg 34
44
Beta-thalassemia with 2 allele mutation
major
| pg 34
45
Which beta-thalassemia presents with subtle hemolysis?
minor
| pg 34
46
Which beta-thalassemia presents with severe hemolysis, severe anemia, extramedullary hematopoiesis, and splenomegaly?
major
| pg 34
47
What is monitored in those with beta-thalassemia minor?
serum ferritin
| pg 35
48
Treatment for those with beta-thalassemia major
repeated transfusions and iron chelation
or bone marrow transplant (high risk)
pg 36
49
Life expectance for those with beta-thalassemia major
~20 years
| pg 36
50
Eventually cause of death for those treated for beta-thalassemia major
iron overload, hemochromatosis, lethal dilated cardiomyopathy
pg 36
51
Radiological findings in those with beta-thalassemia major
"hair on end" or "lace-like trabeculation"
| pg 37
52
A notable facies of beta-thalassemia major
chipmunk facies
| pg 38
53
Hemoglobinopathy with mutated alpha-globin gene
alpha-thalassemia
| pg 41
54
Which is more severe: alpha or beta-thalassemia?
beta-thalassemia
| pg 41
55
What determines the severity of alpha-thalassemia?
```
# of altered genes
pg 41
```
56
1 deletion of alpha-globin
silent carrier of alpha--thalassemia
| pg 42
57
4 deletions of alpha-globins
no O2 capacity, lethal hydrops fetalis
| pg 42
58
Deficiency results in a decrease in GSH
Glucose-6-phosphate dehydrogenase deficiency
| pg 43
59
GDPD is typically asymptomatic until exposed to...
1) infections
2) fava beans
3) ADRs
pg 45
60
Symptoms/signs of G6PD
acute onset, fatigue, pallor, splenomegaly, back/abdominal pain, hemosiderinuria
pg 47
61
Risks of G6PD
males, African descent, areas of endemic malaria
| pg 47
62
Microscopic findings of G6PD
bite cells and Heinz bodies
| pg 46
63
Dark urine upon waking along with an acquired PIGA gene mutation
paroxysmal nocturnal hemoglobinuria
| pg 48
64
PIGA gene mutation results in...
deactivated complement inhibitors
| pg 49
65
Features of paroxysmal nocturnal hemoglobinuria
complement-mediated hemolysis, mild/chronic low-level anemia, increased risk for venous thrombosis
pg 49
66
Treatment for paroxysmal nocturnal hemoglobinuria
antibodies that inhibit MAC, marrow transplant(risky)
| pg 49
67
Repetitive physical trauma to RBCs
traumatic hemolysis
| pg 51
68
Causes of traumatic hemolysis
prosthetic heart valves, narrowing of vessels (microangiopathic hemolytic anemia)
pg 51
69
Schistocytes
"burr cells"
"helmet cells"
pg 52
70
Disease caused by plasmodium falciparum
malaria
| pg 54
71
MC area affected by malaria
Asia and Africa
| pg 54
72
"Blackwater fever"
dark urine associated with malaria
| pg 54
73
Features of malaria
episodic shaking, chills, fever, vomiting sweating jaundice, splenomegaly, HA, joint pain, hemoglobinuria, renal failure
pg 55
74
Malaria with CNS involvement
cerebral malaria
| pg 55
75
Additional features of cerebral malaria
seizures convulsions, coma/death (within days)
| pg 55
76
Treatment for malaria
chloroquine, primaquine, chemotherapy
| pg 55
77
Anemias of diminished erythropoiesis
1) iron deficiency anemia
2) megaloblastic anemias
3) anemia of chronic disease
4) aplastic anemia
5) myelopththisic anemia
pg 56
78
World's MC nutritional deficiency and cause of anemia
iron deficiency
| pg 57
79
____(men or women) store more iron
Men
| pg 57
80
Where is iron stored in the body?
liver, spleen, marrow, skeletal muscle
| pg 57
81
Hb makes up __% of body's iron
80%
| pg 57
82
Iron is transported by...
transferrin (serum ferritin)
| pg 57
83
Conditions creating poor bioavailability of iron
decrease in dietary intake, chronic blood loss (GI or gynecological), malabsorption, increased metabolic demands
pg 58
84
Features of iron deficiency anemia
fatigue, pale skin, lack of energy, impaired cognition, decreased immunity, fingernail "spooning", pica
pg 59
85
Appetite for substances of non-nutritive value
pica
| pg 59
86
A craving for ice is indicative of what deficiency?
iron
| pg 59
87
MC cause of iron deficiency in the US
chronic blood loss
| pg 60
88
Deficiency in folate or vitamin B12 results in what type of anemia?
megaloblastic anemia
| pg 61
89
Folate and vitamin B12 are required for...
DNA synthesis
| pg 61
90
Features of folate deficiency anemia
fatigue, weakness, sore tongue, macrocytes in peripheral blood
pg 62
91
Vitamin B12 is needed for...
DNA synthesis and maintenance of PNS and spinal cord
| pg 63
92
MC cause of vitamin B12 deficiency anemia
chronic malabsorption
| pg 63
93
Features of vitamin B12 deficiency anemia
fatigue, pallor, weakness, dyspnea, demyelination of PNS and CNS, numbness, tingling, burning, decreased proprioception, ataxia
pg 64
94
Treatment of vitamin B12 deficiency anemia
injected vitamin B12
| pg 64
95
Anemia with inflammation decreasing erythropoiesis
anemia of chronic disease
| pg 65
96
Anemia of chronic disease is MC among what population?
hospitalized
(infections, autoimmunity, cancers)
pg 65
97
Features of anemia of chronic disease
similar to iron deficiency anemia + decreased iron-binding capacity and increased iron storage in marrow
pg 65
98
Anemia with suppression of myeloid stem cells, "bone marrow failure", pancytopenia
aplastic anemia
| pg 67
99
Features of aplastic anemia
anemia (weakness, pallor, dyspnea), Thrombocytopenia(petechiae), granulocytopenia (infections)
pg 68/69
100
In which anemia is splenomegaly "characteristically absent"?
aplastic anemia
| pg 69
101
Treatment of aplastic anemia
immunosuppressive meds, regular transfusions, marrow transplant (risky)
pg 69
102
Anemia with extensive marrow infiltration
myelophthisic anemia
| pg 70
103
MC cause of myelophthisic anemia
metastasis to bone (lung breast, prostate)
| pg 70
104
Causes of myelophthisic anemia
met to bone, granulomatous disease, lipid-storage disease
| pg 70
105
Features of myelophthisic anemia
anemia, thrombocytopenia, dacrocytes
| pg 70
106
Treatment for myelophthisic anemia
marrow transplant
| pg 70
107
Where are leukocytes produced?
marrow
| pg 71
108
Leukocytes make up __% of total blood volume
1%
| pg 71
109
Increase in WBCs
leukocytosis
| pg 71
110
Decrease in WBCs
leukopenia
| pg 71
111
Granulocytes
neutrophils, eosinophils, basophils
| pg 72
112
Agranulocytes
monocytes, lymphocytes
| pg 72
113
Categories of WBCs disorders
1) reactive
2) neoplastic
pg 73
114
Decrease in granulocytes
neutropenia <500 cell/microL
| pg 74
115
SEVERE neutropenia
agranulocytosis <100/microL
| pg 74
116
Infection causes by Epstein-Barr virus (HHV-4)
infectious mononucleosis
| pg 76
117
Features of infectious mononucleosis
reactive lymphocytosis, fever, pharyngitis, fatigue, splenomegaly and generalized lymphadenitis
pg 76
118
Microscopic finding of infectious mononucleosis
"atypical lymphocytes"
| pg 77
119
Infectious mononucleosis is most commonly spread via...
saliva
| pg 78
120
Disease caused by bartonella henselae
cat-scratch disease
| pg 80
121
MC population affected by cat-scratch disease
pediatrics (90%)
| pg 80
122
Features of cat-scratch disease
cervical and axillary lymphadenopathy, splenomegaly, pharyngitis, malaise, anorexia, irregular stellate necrotizing granulomas
pg 80
123
Neoplastic proliferations of WBCs
1) lymphoid neoplasms
2) myeloid neoplasms
3) histiocytic neoplasms
pg 81
124
Classifications of lymphoid neoplasms
1) leukemia
2) lymphoma
pg 84
125
WBC cancer involving marrow or blood
leukemia
| pg 84
126
WBC cancer involving lymphatic tissue
lymphoma
| pg 84
127
Sudden onset with abnormal lymphoblasts suppressing marrow
acute leukemia
| pg 85
128
Categories of acute leukemia
1) acute lymphoblastic leukemia
2) acute myeloid leukemia
pg 85
129
MC presenting feature of acute leukemia
anemia
| pg 85
130
Aggressive cancer of lymphoblasts, arrested maturation of B cells or T cells
acute lymphoblastic leukemia
| pg 88
131
MC pediatric leukemia
acute lymphblastic leukemia (80%)
| pg 88
132
Treatment of acute lymphblastic leukemia
chemotherapy
80% cure rate
pg 88
133
Cancer of B cells, MC leukemia of adulthood
chronic lymphocytic leukemia
| pg 89
134
MC age of diagnosis of chronic lymphocytic leukemia
60 years
| pg 89
135
Features of chronic lymphocytic leukemia
pancytopenia, anemia/fatigue. cachexia, generalized lymphadenopathy, hepatosplenomegaly, suppression of B cells
pg 90
136
Prognosis of chronic lymphocytic leukemia
4-6 years
if it becomes aggressive ~1 year
pg 90
137
B cell cancer with a nodular appearance
Follicular lymphoma
| pg 91
138
Lymphocytes with cleaved nuclei
centrocytes
| pg 91
139
Centrocytes are associated with which B cell cancer
follicular lymphoma
| pg 91
140
Follicular lymphoma makes up what % of non-Hodgkin's lymphoma?
40%
| pg 91
141
Features of follicular lymphoma
painless generalized lymphadenopathy, adults >50years
| pg 92
142
40% of cases of follicular lymphoma progress into...
diffuse B cell lymphoma
| pg 93
143
t(14;18), BCL2 gene is associated with which B cell cancer
follicular lymphoma
| pg 93
144
Cancer of B cells with t(11;14)
mantle cell lymphoma
| pg 94
145
Population affected by mantle cell lymphoma
males, >50 years
| pg 94
146
Cancer of B cells, MC lymphoma of adulthood
diffuse large B cell lymphoma
| pg 95
147
Population affected by diffuse large B cell lymphoma
elderly, 60 years
| pg 95
148
Risks for diffuse large B cell lymphoma
EBV infection, immunosuppression
| pg 95
149
Features of diffuse large B cell lymphoma
aggressive, rapidly-enlarging mass(es), commonly extranodally
pg 96
150
Treatment of diffuse large B cell lymphoma
high-dose chemotherapy
(~80% enter remission, 50% cured)
pg 96
151
Cancer of B cells, classically affect African children, "starry ski" histology"
Burkitt lymphoma
| pg 97
152
Risks for Burkitt lymphoma
EBV infection, mutated MYC gene via t(8;14)
| pg 97
153
Population MC affected by Burkitt lymphoma
Africans
| pg 99
154
Fastest growing human tumor
Burkitt lymphoma
| pg 99
155
Burkitt lymphoma MC develops...
extranodally
Africa- maxilla and mandible
USA- abdomen, GI, ovaries
pg 99
156
Prognosis of Burkitt lymphoma
great with aggressive chemotherapy
| pg 99
