9.4- Leukocyte Tests + Coagulation Flashcards
What is leukocytopenia and causes
-Reduced # of WBC in blood
–bone marrow destruction, phenothiazines, suphonanimides
What is lymphocytopenia and causes
Reduced number of lymphocytes
-acute inflammation, corticosteroids, immune def
What is leukocytosis and when is it changed
Elevated WBC
-inf, hemorrage, trauma, malignancy etc
What is lymphocytosis and when is it elevated
Elevated number of lymphocytes
-bacterial inf, protozoal inf, lymphatic leukemias, leukemia + non hodkgins
Signs of haemolotological malignancy
- Lumps in neck,axilla, groin
- splenomegaly
- headaches
- refered pai
Acute myeloid leukemia- age, target, cause, tests
-older age
target: myeloid precursor cells
Cause: bonemarrow blast cells
tests- anemia, leukocytes variable, coagulation ab, LD, Urate increased
Acute lympoid lukemia- age, target, cause, tests
Childhood
target- lymphoid precursor cells
cause- philidelphia chromosome (10-30% of time)
tests- Anemia, throbocytopenia, b lymphocytes
Chronic myeloid leukaemia- age, target, cause, tests,cure
25-45
target- neutrophils + precursors
cause- philidelphia chromosome 95%
tests- urate up
Cure- Slow advance to acute few cure
Chronic lymphocytic leukemia- age, target, tests, cure
elderly
target- b lymphoctes
tests- gamma globulin decreased
cure- slow/rapid varients no cure
Hodgkins lymphoma- age, causem areas, biospy findings, cure
20-30
loc- Nodes, spleen, liver
Biopsy- Reed stenberg
cure- 70-85%
Non hodkins lymphoma: age, loc, biopsy findings, cure
> 50 years
loc- nodes and beyond
biopsy- B or T lymphocytes
cure- 30-40% at best
EBV: age, symptoms, pos tests
Adolescents/young adults
symptoms- malaise, fever, pharyngitis, lymphoadenopathy, spleepnomagaly
Combs, monospot +
What are myelomas and what do they release
Plasma cells in large numbers put out a fragement of immunoglobin (Bence jones proetins)
disease of the old age
Symptoms of myelomas
-low back pain anemia in 90% -vert collapse in 80% -thrombocytopenia, hypercalcemia etc -kidney failure 45%
Tests for myeloma
Urine protein
immunoelectrophoresis for light chains
increased ESR
What light chains will you see in myeloma
kappa or lambda chain
likely monoclonal
Thrombocytopenia- cause, symptoms, diagnosis
causes- marrow failure,short life span, dilution, drugs
symp- nose bleeds, gum bleeds etc
diagnosis- blood smear, bleading time, platelet aggregation time
What is vascular purpura: causes, tests
venous malformation of the skin
causes- asprin, chronic kidney failure, myeloid leukemia, myeloma
tests- CBC, kidney function test
How to find if abnormal coagulation is chronic or aquired
Of chronic then inherited
if acutre than aquired
what are the coagulation inhibitors (3)
- Antithrombin III
- Protein C
- Protein S
Who is haemophilia A found in and what causes it and lab findings
Male
-Factor VIII decreased
lab- APTT slow, Factor VIII low
Who does haemophilia B affect and cuase
Male
Factor IX decreased
What is von willebrands disease and what does it affect
Affects both males and females
-Defect in transpor and stabalizing factor VIII (von willebrands factor)
Lab findings for VonWillebrands disease
- platelets decreased
- PT time normal
- APPT increased
- Factor VIII + Von willebrands factor decreased
What causes a hypercoaguable state (5)
Factor V leiden, Pro S def, Pro C def
Aquired- SLE, cancer
What is Dissemiated intravascular coagulation and efects
Clotting and bleading
- acute respiratory distress
- kidney failure
- adrenal necrosis etc
DIC lab tests/results (6)
- platlets decreased
- PT increased
- APTT increased
- Thrombin time increased
- Fibrinogen increased
- Fibrin degreation products increased
venous vs arterial thrombosis age
venous <40
atrial <30
Thrombophilia causes
- resistence to activated factor V leiden
- pro s def
- pro c def
- antithrombin III def
mc form of inherited thrombophilia
Factor V leiden varient
What are the main thrombosis therapies (3)
Heparin
Warfarin
Thrombolytic therapy
how does herapin work and how it monitored
activates: antithrombin
Inactivates: Prothrombin, Facto Xa, IXa, XIa
monitored by: APTT
(low molecular weight more effective)
Tx for vcerebrovascular accident
clot busters:
tissue plasminogen activator
pro urokinase
