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TEST 1 Flashcards

1
Q

anemias: proliferation

A

-bone marrow not as active to produce RBC or EPO deficient
-Anemia of Chronic disease- inflammation (Rheumatoid Arthritis, lupus, chronic infections, malignancy) -> low EPO
-Renal disease- Deficient EPO
-Fanconi anemia- Inherited aplastic anemia (bone marrow issue)
-Blackfan-Diamond syndrome -> Inherited bone marrow failure
-Parvovirus- Infection causing aplastic anemia (bone marrow can be suppressed) -> temporary
-Drug or toxins

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2
Q

anemia: maturation

A

-B12 deficiency- Perncicous anemia -> poor quality membranes
-Folate deficiency
-Iron deficiency
-Sideroblastic- Iron in the mitochondria has abnormal sequestration (Ringed)
-Lead poisoning- Inhibits heme synthesis & decreased survival of RBC

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3
Q

hemolytic anemias

A

INTRINSIC:
-hemoglobinopathies- thalassemia and sickle cell anemia
-membranopathies- spherocytosis and elliptocytosis
-enzymopathies- G6PD -> oxidative stress or “Heinz bodies”

EXTRINSIC:
-autoimmune
-microangiopathic
-malaria
-blood transfusion
-Rh factor

OTHER:
-infection
-mechanical heart valve
-drugs + toxins
-willsons disease

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4
Q

microcytic anemia

A

-RDW - Low-normal:
-iron deficiency
-sideroblastic
-thalassemia
-anemia of chronic ds

-RDW - High:
-immune hemoyltic
-membrane/enzyme hemolytic:
-spherocytosis- loss of biconcave

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5
Q

normocytic anemia

A

-RDW- Low-normal:
-bleeding
-Iron, B12, folate deficiency (early)
-meds
-chronic anemia disease
-IF NOT:
-RBC asplasia
-myelodysplasia
-paroxysmal nocturnal hemoglobinuria

-RDW- High:
-Coombs+ -> hemolytic
-Coombs-:
-hemoglobinopathies and membranopathies
-G6PD
-microangiopathic anemia

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6
Q

normocytic anemia: multiple cytopenia

A

-low RBC, leuko, or platelets
-myelodysplasia
-bone marrow infiltration
-aplastic anemia

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7
Q

macrocytic anemia

A

-RDW- Low-normal:
-B12 or folate deficiency*
-hypothyroidism
-down syndrome
-liver disease
-meds
-IF NOT: myelodysplasia

-RDW- High:
-blood loss
-hyporegenerative anemia
-hemolytic

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8
Q

ethrocytosis

A

-Hgb is high
-primary polycythemia:
-myeloproliferative neoplasm
-reactive erythrocytosis
-spurious erythrocytosis- dehydration

-secondary polycythemia:
-smoking
-high altitude
-lung disease/fibrosis
-renal cell carcinoma
-cerebellar hemangioblastoma

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9
Q

neutrophils

A

-40-70%
-LOW:
-bone marrow depression- chemo
-typhoid, measles, rubella, lupus

-HIGH: LEFT SHIFT:
-acute infection
-rise in bands (immature)

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9
Q

lymphocytes

A

-LOW:
-heart failure
-renal failure
-corticosteroid therapy

-HIGH:
-TB
-syphilis
-pertussis
-autoimmune ds
-ulcerative colitis

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10
Q

monocytes

A

-high- bacterial infection or viral

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11
Q

eosinophils

A

-LOW:
-stress
-trauma
-surgery
-cushing syndrome

HIGH:
-allergies
-skin disease
-parasitic infection

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12
Q

basophils

A

-LOW:
-pregnancy
-hyperthyroidism

HIGH:
-allergic rxn
-histamines
-ulcerative collitis

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13
Q

lymphoid and myeloid neoplastic proliferation

A

-LYMPHOID - lymphoma
-B cell neoplasm- bone -> lymph -> circulation
-antibody production

-T & NK neoplasm -> thymus -> circulation
-cellular immunity

-MYELOID
-acute myeloid leukemia- neoplasm of hematopoietic stem cell -> WBC don’t differentiate -> blasts in marrow
-myeloproliferative- proliferation of myeloid cells
-myelodysplastic (MDS)- precancerous (<20% blasts) -> decreased myeloid cells

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14
Q

hodkins and nonhodkins lymphoma

A

-HODKINS:
-local
-contiguity
-extranodal sites are RARE
-B cells, Reed-Sternberg cells

-NON-HODKINS:
-multiple groups of nodes
-noncontiguously
-extranodal sites

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15
Q

Bleeding disorders: hemophilia A, hemophilia B, Von Willebrands disease, Thrombocytopenia

A

-Hemophilia A- low factor 8 -> hemorrhage, increase PTT

-Hemophilia B- low factor 9 -> christmas disease -> increase PTT

-Von Willebrands ds- low von willebrands factor
-MC clotting disorder
-increase bleeding time

-thrombocytopenia- low platelets
-petechiae
-immune, drugs, post viral, transfusion rxn, sepsis

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16
Q

bleeding and clotting time WNL

A

-bleeding - 1-3 mins
-clotting - 8-15 mins

17
Q

prothrombin time

A

-varies
-extrinsic and common pathway
-1, 2, 3, 5, 7, 10
-increased with warfarin, liver disease, vit K deficiency, massive blood transfusion, hypothermia, intravascular coagulation
-fibrinogen (1) and prothrombin (2) are tested
-extrinsic pathway is triggered by damage to endothelial tissue

18
Q

platelets

A

-high- high altitude, exercise
-low- viral infections, drug rxn

19
Q

partial thromboplastin time (PTT)

A

-intrinsic and common pathway
-1, 2, 5, 8, 9, 10, 11, 12
-tests for fibrin (1), and prothrombin (2)

20
Q

lactate dehydrogenase (LDH)

A

-high in cardiac, RBC, hemolysis, renal disease
-non specific

21
Q

alkaline phosphatase (ALP)

A

-HIGH:
-pregnancy
-liver disease and obstruction
-bone diseases:
-bone tumors
-osteoporosis
-rickets
-padget’s disease
-hyperparathyroidism
-leukemias and lymphomas

-LOW:
-hyperphosphatasia
-aplastic anemia
-Willsons ds
-cretinism
-chronic myeloid leukemia
-pernicious anemia

22
Q

GGT

A

HIGH
-liver disease
-cancer of prostate, breast or lung
-pancreatitis
-SLE
-indicate hepatobiliary ds

LOW
-hyperthyroidism
-hypothalamic dysfunction

23
Q

synthetic liver function hypoalbuminemia

A

HYPOALBUMINEMIA
-liver disease
-kidney disease- nephrotic syndrome
-malnutrition
-burn

-PT and INR- 1,2,5,7,10

-transthyretin/prealbumin- malnutrition

-albuminuria- DM and HTN renal pathology

24
pancreatitis
-biliary tract obstruction -alcohol -idiopathic -cell destruction with scar formation -amylase/lipase 3x -chronic- DM -CA 19-9 tumor marker for exocrine pancreatic cancer
25
creatinine
-LOW- low muscle mass, malnutrition -HIGH- muscle breakdown, kidney disease, dehydration -CrCl= (140-age)(wt kg)/(SCr)(72) (x .85 if female) -> needed for dosing
26
BUN
-10/12-20 -LOW BUN/Cr- starvation, low protein low muscle mass, severe liver disease, acute tubular necrosis -HIGH BUN/Cr- prerenal uremia, GI bleed, high protein diet, dehydration, increased urea (ex. steroid therapy) -HIGH BUN with HIGH Cr- prerenal uremia with renal disease, postrenal obstruction -GI bleed- lower volume state and increase urea
27
renal failure symptoms and causes
-flank tenderness -rash- nitrogen deposits into skin -oliguria <500, anuria <100 -hematuria -casts, proteinuria, pyuria -HTN -> renal artery stenosis -AV knicking -abdominal bruit- RAS, AAA -peripheral neuropathy -basement membrnae -vascular disturbance -low flow state- acute -obstruction- renal artery stenosis, kidney stone -HTN and DM
28
azotemia
-nitrogen and wastes in blood -prerenal: <35% -restricted flow -renal artery stenosis, hemorrhage, hypotension, CHF -dehydration- GI, renal, skin, third space* -renal: -vessels, glomerulus, tubules, mesangium -autoimmune- lupus -glomerular nephritis -meds -postrenal: -narrow ureters, AAA, tumor -stone -congenital -inflammatory lesion -neoplasm
29
dehydration: GI, renal, skin, third space
-Hmg- high, albumin- low, Cr- high, BUN- high -causes prerenal azotemia -GI- vomiting, diarrhea, bleeding, external drainage -renal- diuretics, osmotic diuresis, salt wasting nephropathies (nephrotic syndrome), hypoaldosteronism -skin- sweat, burns -third space- intestinal obstruction, crush injury, fracture, acute pancreatitis
30
nephrotic syndrome vs nephritic
-NEPHROTIC: -hypoalbuminemia -> proteinuria -hyperlipidemia -edema- third space edema -NEPHRITIC: -inflammation of renal tissue/glomeruli -HTN -can be infectious -mild edema -proteinemia -hematuria + RBC casts
31
proteinuria
-glomerular (basement membrane) issue- diabetic neuropathy -overflow (spilling)- monoclonal immunoglobin "M spike" -> multiple myeloma -> Bence-Jones proteins -acute and chronic pyelonephritis -overflow can also be rhabdo -postrenal proteinuria- UTI
32
sodium excretion
->1% excretion is abnormal -acute tubular injury/necrosis or disease -inaccurate with diuretic use -FENa = (UNa)(PCr)/ (PCr)(SNa) x 100
33
fractional urea excretion
-prerenal azotemia- <35% FEUrea -can be done with diuretic use -FEUrea= (UUr)(PCr)/(UCr)(PUr) x 100
34
quantity of urine
-polyuria- diabetes mellitus, diabetes insipidus, nervous diseases, chronic nephritis, diuretics -oliguria- acute nephritis, heart disease, fever, eclampsia, diarrhea, vomiting, inadequate fluid intake -anuria- uremia (nitrogenous waste in blood), acute nephritis, metal poisoning, complete obstruction of urinary tract
35
specific gravity
-specific gravity is proportional to volume -chronic low- insipidus, acute tubular necrosis -chronic high- DM (volume large), SIADH, dehydration, CHF, infection
36
acidity of urine
Acidic- acidosis, DM, fevers, starvation -uric acid and cystine crystals form in acidic urine -Alkaline- UTI, vegetarian diet (urea -> ammonium), infection or ingestion of alkaline compounds -calcium phosphate and struvite (UTI!!) crystals form in alkaline urine
37
kidney stones
-connections to bladder, exiting kidney, psoas muscle -calcium stone- calcium oxalate MC, hyperparathyroidism -uric acid- due to low urine output, high protein, alcohol, IBD, gout -> not visible on x-ray -struvite- urinary infection -cystine stone- inherited, young pts
38
urinary casts
39
heme in urine
-hematuria- stone, tumor, UTI, nephritic syndrome -myoglobin- rhabdo
40
common UA

Clin Lab (14 decks)

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