test 1 Flashcards
(131 cards)
1
Q
What is hemolytic anemia due to - inadequate marrow production or RBC destruction?
A
RBC destruction
2
Q
Does Reticulocyte count increase or decrease in hemolytic anemia?
A
Increase
3
Q
Do we see jaundice in hemolytic anemia? Why or Why Not?
A
Yes, hemolysis results in increase heme catabolism and enhanced formation of bilirubin
4
Q
What does a positive direct coombs test indicate?
A
It means you have anitbodies that act against your red blood cells
5
Q
What conditions are direct coombs test positive in?
A
Autoimmune hemolytic anemia, Systemic lupus erythematosus
6
Q
What are the three genetic forms of anemia?
A
1) Sickle Cell anemia
2) Thalassemia
3) Glucose-6-phosphatase dehydrogenase (G6PD) deficiency
7
Q
Sickle cell anemia?
A
1) Hemoglobinopathy
2) Hgb 5
3) Normocytic anemia
4) Sickle-shaped RBCs clog capillaries
8
Q
What does a Dx of sickle cell anemia require?
A
Hb electrophoresis
9
Q
What does glucose-6-phosphatase dehydrogenase (G6PD) deficiency anemia require?
A
1) G6PD (an enzyme) is deficient
2) too little G6PD leads to the destruction of red blood cells (hemolysis), so increase reticulocyte count
10
Q
What is thalassemia?
A
An abnormal Hgb which leads to premature destruction of RBC, which leads to high reticulocyte count
11
Q
What anemia is due to bone marrow failure?
A
1) aplastic anemia
2) secondary invasion of marrow
12
Q
What is aplastic anemia?
A
pancytopenia (decrease in all blood cell counts) d/t bone marrow suppression
13
Q
what is the etiology of aplastic anemia?
A
chemotherapy
some medication
some chemicals (benzene, …)
14
Q
Polycythemia can be ____ or _____
A
primary or secondary
15
Q
What is the definition of polycythemia?
A
HCT > 55 for men, 50 for women when not d/t dehydration
16
Q
What is there an increased risk of in polycythemia?
A
clot formation
17
Q
what is the polycythemia vera a cancer of?
A
RBC
18
Q
What is the treatment for polycythemia?
A
1) low dose aspirin for all patients
2) myelosupppressive drugs (bone marrow suppressive)
3) phlebotomy
19
Q
Can secondary polycythemia happen in renal cell cancer? Why?
A
Yes, d/t increased EP production in the KD
20
Q
What are causes of secondary polycythemia?
A
1) obstructive sleep apnea
2) obesity hypoventilation syndrome
3) COPD (chronic obstructive pulmonary disease)
4) heavy cigarette smoking
21
Q
What is the tx of secondary polycythemia?
A
Treat the underlying cause
22
Q
What 3 WBCs are granular?
A
1) Neutrophil
2) Eosinophil
3( Basophil
23
Q
What 2 WBCs are agranular?
A
lymphocyte and monocyte
24
Q
Which is higher, the percentage of neutrophil or lymphocyte?
A
neutrophil
25
Basophil is less than other WBCs, true or false?
True
26
What do basophils release?
histamine
27
What is neutrophil against?
bacteria
28
What do eosinophils kill?
parasites
29
what do monocytes ingest?
dead cells
30
How many types of lymphocytes are there and what are they?
3
1) B: secret antibody
2) T: orchestrate the overall immune response
3) NK: destroys virus and cancer cells
31
What is leukopenia?
decreased leukocytes
32
what is neutropenia?
decreased neutrophil
33
what is thrombocytopenia?
decreased throbocytes
34
what is the etiology of leukpoenia?
some drugs
autoimmune disorders (antibody against wbcs): RA, SLE
infection: HIV, overwhelming sepsis
35
what is the cause of leukopenia?
infection
36
what is leukocytosis vs leukemia?
leukocytosis: increased wbc (around 16k-20k) it is not cancer
leukemia: increased wbc (around 100k-250k) cancer of wbc
37
what is the etiology of infectious mononucleosis (IM)
1) etiology: EBV
2) increased number of lymphocytes (lymphocytes are mono nuclear
3) more common in children
4) sx in children: asymptomatic
5) sx in adults: fever, sore throat, enlarged lymph nodes in the neck, and tiredness
38
What is the test for IM?
monospot test (heterophil test)
39
Leukocytosis can be ___ or ___
primary or secondary
40
primary leukocytosis is ...
leukemia (cancer of wbc)
41
primary polycythemia is
polycythemia vera (cancer of rbc)
42
primary thrombocytosis is
thrombocythemia (cancer of platelets)
43
What is cancer of the lymphatic system?
Lymphoma (lymphoma is considered cancer of lymphocytes also
44
What is secondary leukocytosis due to?
infection, stress
45
how many types of leukemia are there and what are they?
2
1) myelogenous leukemias from myeloid stem cell
2) lymphocytic leukemias and lymphomas from lymphoid stem cell
46
what are acute leukemias?
ALL, AML
47
what are chronic leukemias?
CLL, CML
48
what are the four main facts about Acute Myelocytic Leukemia
1) most common type of leukemia
2) 20-40 yo
3) more in patients that had chemo
4) massive number of immature neutrophils in bloodstream
49
what are the three main facts about Acute lymphocytic leukemia?
1) immature lymphocytes
2) most frequent form of leukemia in children
3) most common cancer in children
50
what are the four facts about chronic myelocytic leukemia (CML)
1) not as common as other leukemias
2) 40-60 years old
3) more in patients that had radiation previously
4) it can be asymptomatic
51
What are the major facts of chronic lymphocytic leukemia (CLL)
most common chronic leukemia
most common adult leukemia
more in elderly (more than 65)
52
what are the sx of chronic lymphocytic leukemia?
```
enlarged, but painless lymph nodes
fatigue
fever
pain in the upper left portion of the abdomen, which may be caused by an enlarged spleen
night sweats
weight loss
frequent infections
```
53
what creates the lymphatic system
```
lymph
lymph node
tonsil
thymus
spleen
bone marrow
```
54
where do t cells mature?
thymus
55
where do b cells mature?
bone marrow
56
what is tonisilitis?
infection of tonsils
| more common in childhood
57
how many types of lymphoma are there, and what are they called?
Hodgkin lymphoma and non hodgkin lymphoma
58
what are the specific cells in hodgkin lymphoma?
Reed-Sternberg cells (malignant mature B cells)
59
Are swollen lymph nodes painful or painless in lymphoma?
Painless
60
If you have a painless lump in the breast, lymph nodes what do you need to rule out?
cancer
61
If you have a painful lump in the breast or painful lymph nodes what do you need to rule out?
infection
62
What is the function of platelets?
stop bleeding with coagulation factors (Factor VIII)
63
what are the fragments of cytoplasm?
platelets
64
Platelets are derived from?
megakaryocytes of the bone marrow
65
True or false? A platelet is larger than WBCs and RBCs?
False
66
What is a normal platelet range is?
150k - 450k
67
What is thrombocytopenia?
having less than 150k platelets
68
what is thrombocytosis
having more than 450k platelets
69
Do you see excess bleeding or blood clots in thrombocythemia?
It can be both, excess clotting or bleeding depending upon whether platelets are normal or defective
70
What is the dx of thrombocythemia?
increased platelets in CBC (2-4 times more than normal)
71
what are the main facts about hemophilia?
inherited genetic d/o
impairs the body's ability to make blood clots - people bleed longer after an injury, easy bruising, and an increased risk of bleeding inside joints
72
how many types of hemophilia
hemophlia A (80% of cases) is d/t not enough clotting factor VIII hemophlia B: d/t not enough clottting factor IX
73
What is the dx of hemophilia?
measuring amout of factor VIII and IX in blood
74
what is the tx for hemophilia?
transfusion of missing clotting factors
75
What is hematology?
blood related
76
what is cbc?
rbc, wbc, platelets, hbg, hct, mcv
77
what has no nucleus?
rbc, platelets
78
what are the other names of rbc, wbc, plt?
erthrocytes, leukocytes, thrombocytes
79
what is the hct?
the percentage of the cells (rbc, wbc, plt) in blood volume
80
what is whole blood minus plasma
formed elements
81
what is hemoglobin
most abundant protein in rbc
82
what is the definition/breakdown of hemoglobin
hem + globin
hem: contains iron
globin: protein
83
what is the normal range of hbg for males and females?
12-14 female
| 14-16 male
84
Is reticulocyte a stem cell?
no, it is an immature rbc
85
what does a reticulocyte of less than 1% indicate?
inadequate marrow production
86
A reticulocyte of more than 4% indicates
rbc destruction or blood loss
87
what is one example of rbc indices?
mcv (mean corpuscular volume)
88
how do you use mcv?
for classifying anemia
89
what is a normal mcv?
80-96
90
what are examples of normocytic, macrocytic and microcytic anemia?
normocytic: bleeding
microcytic: iron def anemia
macrocytic: B12 def, B9 def
91
anemia can be due to
underproduction or increased destruction
92
if the patient has anemia, acupuncturists look at the tongue, western doctors look at
conjunctiva
93
what is a blood smear test for?
number and shape of blood cells (RBC, WBC, PLt)
94
what is the most common anemia in the US
microcytic anemia
95
if you see iron deficiency in men or postmenopausal women what is the next step
GI work up, fecal occult blood test to rule out colon cancer. Colorectal cancer is the 3rd common cancer both in men and women
96
What are the specific sx of iron deficiency anemia?
pica, spoon shaped nails
97
What are the lab results in iron def anemia?
low mcv, low serum iron, low ferritin (iron storage) high iron binding capacity (fe tibc)
98
what is the tx for iron def anemia
iron supplement
99
how can you confirm your dx of iron def anemia?
check reticulocyte count in two weeks, it must be improved
100
what is vitamin b12 def anemia?
macrocytic anemia, high mcv
101
what is the etiology of b12 def?
pernicious anemia
interference with b12 absorption (crohn's disease)
inadequate dietary intake (rare-seen in vegetarians)
102
what is pernicious anemia?
subcategory of b12 def
| can't absorb b12 d/t lack of intrinsic factor
103
where is the intrinsic factor made?
parietal cell of stomach
104
what is the specific sx of vit b12 def
neurological sx (tingling, ataxia,dementia)
105
what is the schillings test
measures body's ability to absorb b12
106
what sample is collected in schillings test?
urine
107
what are the other names of vit b12, b9, vit c
b12: cobalamin
b9: folic acid
c: ascorbic acid
108
what is folic acid def
macrocytic anemia
109
sx of b12 def vs b9 def
b9 doesn't have neurological sx
110
what is the etiology of folic acid def?
```
decreased intake (alcoholism, poor diet)
increased demand (prego)
impaired absorption (celia, ibd)
medications (phenytoin)
```
111
what is another word for cancer?
carcinoma
112
what are cancers characterized by?
unregulated growth and spreading of cells that differ structurally and functionally from the normal cells from which they developed to other parts of the body
113
def of metastases
ability of malignant cells to invade into surrounding tissues and possibly spread to more distant sites in the body by invading the bloodstream and or lymphatic vessels
114
what is the second most common cause of death in the US
cancer
115
what is the leading cause of cancer death in the US
lung
116
what are the three most prevalent cancers in men
1) prostate
2) lung
3) colorectal
117
what are the three most prevalent cancers in women
breast
lung
colorectal
118
what is the leading mortality of cancer in males
lung
prostate
colorectal
119
what is the leading mortality of cancer in women
lung
breast
colorectal
120
does a tumor mean cancer?
no, a tumor can be benign or malignant
121
as a rule the more bizarre cancerous cells become, the more _____
aggressive and malignant is their behavior
122
all causes of cancer act by ___, specifically causing mutations in ___
generating damage to the cells DNA
| proto-oncogenes and tumor suppressor genes
123
tumor suppressor genes act as
negative regulators of cell growth and suppress or check the unregulated growth of cells
124
example of a tumor suppressor gene
P53
125
If a proto-oncogene acquires a mutation ____
they become oncogenes (cancer promoting genes)
126
if a tumor suppressor gene acquires a mutation _____
abnormal growth goes unchecked
127
why are most cancers more common in old age
the longer we live the more chance there is for the genes that regulate cell proliferation to become damaged by exposure to agents that damage our DNA
128
4 examples of carcinogens
tobacco smoking, alcohol, sunshine/UV radiation, chemical carcinogens (benzene)
129
does hrt (hormone replacement therapy) increase risk of breast cancer?
yes
130
can viruses cause cancer?
```
yes
HPV - cervix
Hepatitis B & C - LV
Epstein -Barr Virus (non hodgkins
cytomegalovirus (kaposis sarcoma - AIDS
```
131
what diet is protective against bowel cancer
a high fiber diet
