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Jenna's Shit List > Shit - Heme > Flashcards

Shit - Heme Flashcards

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1
Q

Platalets:

  • lifespan
  • dense granules
  • alpha granules
A
  • lifespan 8-10d
  • dense = APD and Ca
  • alpha = vWF and fibrinogen
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2
Q

Neutrophils:

  • specific granules:
  • azuriphilic granules:
A

specific = ALP, collagenase, lactoferrin, lysozyme* (cell wall breaking)

Azurophilic = proteinase, acid phosphatase, MPO (makes green pus), b-glucuronidase

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3
Q

Macrophages and shock

A

Macro CD14 —-Lipid A of LPS

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4
Q

causes of eosinophilia

A

Il-5, asthma, allergy, neoplasia, parasites, chronic adrenal insufficiency

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5
Q

Content of eosinophils vs basophils vs mast cells

A

eos = MBP and histaminase

baso = histamine, heparin, late LTs

mast = histamine, heparin, tryptase, eosinophil chemotactic factor

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6
Q

Prevention of mast cell degranulation

A

Cromolyn sodium

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7
Q

NK markers

A

CD16 and CD56

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8
Q

Kleihauer-Betke test

A

%HbF in maternal blood, determines rhogam dosing

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9
Q

Extrinsic coagulaton pathway: players and test

A

VII to VIIa by III

III = thromboplastin = tissue factor; activated by endothelial injury

PT

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10
Q

plasminogen to plasmin

A

tPA (endogenous)

Alteplase, reteplase, streptokinase, tenecteplase

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11
Q

Stops plasmin formation:

A

a2-anti-plasmin (endogenous)

Aminocaproic acid

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12
Q

Factors activated by vit K

A

II, VII, IX, X, C, S

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13
Q

Protein C role

A

Inactivate Va and VIIIa

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14
Q

Factor V liden mutation

A

Factor V that can’t be inactivated by protein C –> clotting disease

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15
Q

Antithrombin inactivates:

enhanced by:

A

II, VII, IX, X, XI, XII

*most important = II and Xa

enhanced by heparin

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16
Q

Platelet activation:

  • activated by:
  • release:
A

Activated by platelet GpIb ——- vWF—endotheium

Release ADP, CA and TXA2

ADP ——ADP-R of other platelets –> GPIIb/IIIa espression, which binds fibrinogen causing platelet aggregatoin

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17
Q

Where does vWF come from?

A

Weibel-palade bodies of endothelium

Alpha-granules of platelets

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18
Q

ADP-R inhibitors

A

Clopidogrel, prasugrel, triclopidine

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19
Q

Direct GPIIb/IIIa inhibitors

A

Abciximab, eptifibatide, tirofiban

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20
Q

Ristocetin

A

promotes vWF — GpIb

decreased agglutinatoin in test indicated von Willibran disease or bernard soulier (GpIb deficiency)

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21
Q

Direct thrombin inhibitors:

A

agatroban, dabigatran, bivalirudin

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22
Q

Direct Xa inhibitors

A

Apixaban, rivaroxaban

*fondaparineux

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23
Q

Spur cells (acanthocytes)

vs echinocyte (burr cell)

A

spur = liver disease, abetalipoproteinemia, vit E deficiency

burr = EDTA artifact, uremia, PK deficiency, hypo-Mg, hypo-P, hemolytic anemia, mechanical damage

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24
Q

Basophilic stippling vs ringed sideroblasts

A

basophilic stippling = lead poisoning

ringed sideroblasts = sideroblastic anemia, IRON in the mitochondria becasue d-ala-synthase deficiency MA (also can be from lead poisoning)

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25
bite cells other name:
degmacyte
26
target cells:
HbC, Asplenia, Liver disease, Thalassemias
27
Plumer-Vinson
IDA, esophageal webs, atrophic glossitis
28
alpha-thal - chrom/problem - Types
Cr16; deletions cis = asian = same strand (worse, creates HbBarts) trans = african = different HbBarts = hydrops = 0/4 HbH = 1/4
29
Beta-thal - chrom/problem - types
Cr 11, point mutations in spice sites/promoters Medeterranian Major = high HbF Minor = high HbA2
30
Lead roles:
Blocks ALA-dehydratase (2) and ferrocheletase (7, last) Inhibits rRNA degradatoin (basophilic stippling) Causes sideroblastic anemia S/S foot/wrist drop, encephalopathy, GI
31
Lead poisoning Rx
Dimercaprol EDTA Succimer (kids) Penicillamine
32
Causes of sideroblastic anemia
Hereditary: ALA synthase (1, RLS); XR Acquired: MDS Reversible: alcohol, lead poisoning, B6 defic., Cu defic., INH
33
Drug causes of folate deficiency
TMP, MTX, phenytoin
34
Orotic aciduria: cause labs
UMP synthase deficiency (AR); builup of orotic acid, no pyrimidine de novo Megaloblastic anemia refractory to B9 and B12, orotic acid in urine, **NO** hyperammonemia
35
Non-megaloblastic macrocytic anemia causes
alcoholism liver disease hypothyroidism reticulocytosis 5-FU
36
hepcidin - MOA - disease and causes - Rx
ARP form liver, increase by inflammation (or high Fe) blocks ferroportin, preventing intestal cells from BL transport to transferrin, and macrophage release ACD: SLE, RA, neoplasm, CKD Rx = EPO
37
Aplastic anemia - causes - S/s
Causes: - radiation.drugs (benzene, alkyl, **chloramphenicol**) - B19, HIV, HCV, EBV - Fanconi anemia S/s: fatigue, infections, bleeding (petechiae, purpura)
38
Hemolytic anemia in a newborn
Pyruvate kinase deficiency
39
PNH: triad and long-term sequale
Triad = Coombs negative HA, pancytopenia (acquired SC defect), venous thrombosis (RBCs relelase pro-coagulant stuff) Increased incidence of ALL
40
HbS vs HbC mutations Test for both
both Cr.11 pos 6 HbS = valine (/) for glutamate (-); H-phobic, sickles HbC = lysine (+) for glutamate (-) \*think about electrophoresis bands\* Test = sodium metabisulphite screen (both will sickle)
41
AHA warm vs cold: coombs, causes, and Abs
Coombs + Warm = IgG = SLE and CLL Cold = IgM = mycoplasma, mono, malignancy, CLL
42
Pregnancy/OCP effect on iron handling
increases TIBC(transferrin); so decreases %transferin saturation
43
Corticosteroids on blood cell profile
Neutrophilia (prevents extravasation) Eosinopenia (sequesters them in LNs) Lymphopenia (apoptosis)
44
Lead poisoning steps affected + location + buildup
2 = ADA dehydratase = cytoplasm = d-ALA 7 = ferrocheletase = mitochondria = iron and protoporphyrin
45
Acute Intermittent Porphyria step blocked and buidup Exacerbated by: Rx:
3 = porphobilinogen deaminase = PBG buildup Exacerbated: 450 inducers, alcohol, starvation Rx = glucose
46
Porphyria cutanea tarda enzyme and buildup:
Uroporphyrinogen decarboxylase; uroporphyrinogen III buids up
47
Iron poisoning microscopy and major s/s
Membrane lipid peroxidation GI bleed
48
Desmopresin Rx for:
Hemophilia A (VIII) and vWF deficiency | (endothelial release)
49
Cagualtion factor inhibitor disease
Abs to CFs MC = VIII; looks like hemophilia A, but when you mix it with test blood PTT doesnt normalize becasue the ABs just attack the fresh cells
50
Bernard soulier defect
GpIb of platelets (doesnt bind vWF on endothelium) no agglutination with ristocetin
51
Glanzmann's Thromblasthenia
GpIIb/IIIa deficiency no platelet crosslingking because cant bind fibrinogen
52
ITP Rx
Anti-GpIIb/IIIa Rx = steroids (decrease Ab production via lymphocyte apoptosis), IVIG (gives Abs something else to bind)
53
Killer T-cell MOA killing
Perforin and granzyme --\> activate CASPASES
54
Features of anaplastic cells
loss of polarity, nuclear polymorphism, irregular mitoses, high N:C, **giant multinucleated tumour cells**
55
etoposide/teniposide inhibit: topotecan/irinotecan inhibit:
topo II reannealling their dsDNA breaks topo I \*1 can has 2 sides\*
56
Rb-P means:
inactivated cell can progress thru cell cycle (G1 to S)
57
Role of protecin C (and S)
deactivate factors V and VIII by proteolysis
58
59
AT-III deficiency labs, cause
NORMAL PT, PTT, TT Heparin deos NOT increase PTT AD or acquired (proteinuria)
60
Propthombin 20210A mutation
Point mutation in 3'UTR, which increases protheombin production
61
Fibrinolysis disorders
radical prostatectomy (urokinase release) liver cirrhosis --\> low a2-anti-plasmin s/s = DIC but NORMAL platelet count; increased fibrinogen split products (not fibrin) Rx = aminocaproic acid (inhibits plasminogen)
62
Cryoprecipitate: contents and when its used
Fibrinogen, vWF, VIII, XIII, fibroniectin Fibrinogen or VIII deficiencies
63
CD 15 and CD30+
Reid Sternberg Hodgkins B-cell lymphoma
64
Types of Hodgkins lymphoma + histology
Reid-sternberg owl-eyes Nodular sclerosing: M=F, 70%, cervical or mediatinal, lacunae Lymphocyte risk: good Px Mixed or Lymphocyte depleted: bad Px
65
Types of burkitts + location
Endemia = africa = jaw Sporatic = pelvis or abdomen Immunodeficient
66
painless waxing and waning LAD: Dx
Follicular lymphoma (bcl-2; 14;18)
67
mantle cell TL and CD
11;14, CD5
68
ATCL s/s
lytic bone lesions, hypercalcemia, generalized LAd with HSM
69
mycoses fungioides vs. sezary syndrome Histo
MF = cutaneous, lymphoma SS = cutaneous and systemic, leukemia Criberiform nuclei
70
lytic bone lesions in MM: pathophysiology
Neoplastic B-cells secrete Il-1 and IL-6 IL-1 activates osteoclasts
71
MM vs MGUS vs WM
MM = IgG (MC) or IgA M-spike with CRAB s/s MGUS = IgG or IgA spike with NO s/s (can become MM) WM = IgM M-spike, hyperviscocity syndromes (blurred vision, raynauds)
72
Myelodysplastic syndrome: disease, causes, sequale
de novo mutation or enviro (benzene, radiation, chemo) \>20% blasts = AML
73
Pseudo-Pelger-Huet anomaly
bilobed PMNs, seen after chemo
74
Sickle cell and MCHC
high via RBC dehydration

Jenna's Shit List (23 decks)

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