Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

USMLE Pathoma > Anemia & thrombo (crash cards) > Flashcards

Anemia & thrombo (crash cards) Flashcards

1
Q

Iron deficiency anemia

Pathology:

Symptoms/Signs:

A

Path:
Microcytic & hypochromic anemia with:
Low iron
Low ferritin
High TIBC

Signs:
- Koilonychia
- Pica
- Fatigue/weakness
- Pallor
- Plummer Vinson synd
(iron def anemia, esophageal webs, dysphagia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Commonly causes what type of anemia?

  • diet
  • menorrhagia
  • peptic ulcers
  • tape worms
  • colon cancer
  • Pregnancy
  • Breast fed only babies
A

Iron deficiency anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Anemia of chronic disease

Pathology:

Symptoms/Signs:

A

Anemia due to a chronic condition with:
Low iron
Low TIBC
High ferritin

Signs:
- Increased hepcidin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Polycythemia vera

Pathology:

Symptoms/Signs:

A

A JAK 2 kinase mutation resulting in More RBC’s but low EPO & normal SaO2 resulting in hypocellular and fibrotic bone marrow

Signs:
- Hepatosplenomegaly
- Erythromelalgia
- Budd-Chiari syndrome
- Thrombotic episodes
- Aquagenic pruritus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Secondary appropriate Polycythemia

Pathology/Causes:

A

Path:
More RBC’s with high EPO but Low SaO2 seen in high altitude dwellers, Smokers, or people with right to left shunts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Secondary inappropriate Polycythemia

Pathology/Causes:

A

Paraneoplastic EPO production from cancers (renal, liver, cerebellar) that results in high EPO, RBC’s but normal SaO2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Anemia of chronic renal failure

A

Path:
Normocytic & normochromic anemia from renal failure that causes low Hb (<10) & low EPO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Alpha thalassemia

Pathology:

A

Path:
a-globin deletion results in microcytic anemia with high levels of RBC’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Anemia cells:

Spherocytes

A

Hereditary spherocytosis &
Immune hemolytic anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Anemia cells:

Macro-ovalocytes & hypersegmented PMN;s

A

Megaloblastic anemias (B12, Folate, & Orotic aciduria)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Anemia cells:

Target cells

A

HbC disease
&
Thalassemias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Anemia cells:

Sickled cells

A

HbSC disease
&
Sickle cell disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Anemia cells:

Iron granules

A

Sideroblastic anemia
&
Lead poisoning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Anemia cells:

Howell-Jolly bodies

A

Sickle cell disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Anemia cells:

Basophilic stippling

A

Sideroblastic anemia
&
Thalassemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Anemia cells:

Heinz bodies
Bite cells
Blister cells

A

G6PD deficiency anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Alpha thalassemia’s:

Minima

A

asymptomatic

1 a-globin deletion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Alpha thalassemia’s:

Minor

A

2 deleted a-globin’s
Cis (Asians)
Trans (Afro amer)

mild microcytic & hypochromic anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Alpha thalassemia’s:

Major

A

3 deletions of a-globin’s

Excess B-globin causes mod-severe microcytic hypochromic anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Alpha thalassemia’s:

Hydrops fetalis (Barts disease)

A

All a-globin’s are deleted causing y-globin excess (aka HbBart Hb) which has a high affinity for O2 hogging it from tissues.

Severe tissue hypoxia = death (in utero or immediately post birth)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Anemias:

Microcytic
Hypochromic
High HbF
High HbA2

A

Beta Thalassemia

Common in AA & Mediterranean people

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Beta Thalassemia:

  • Point mutation in splicing of intro & Promoter region
  • Low B-globin production
  • High HbA2
A

B-thalassemia minor

Heterozygote:
Mild microcytic hypochromic anemia

23
Q

Beta Thalassemia:

  • Point mutation in splicing of exon & Chain terminator
  • High HbF
  • High HbA2
  • Target cells
A

B-Thalassemia Major

Homozygote: No b-globin

  • Severe microcytic & hypochromic anemia
  • Aniso poikilocytosis (need rec. blood transfusions)
  • Crew-cut skull
  • Chipmunk face
  • Hepatosplenomegaly
  • Sequestration crisis (B19 parvovirus)
24
Q

Lead poisoning

Pathology:

Symptoms/Sign:

A

Lead poisoning results in microcytic-hypochromic & sideroblastic anemia with high levels iron, ferritin but with low or normal TIBC

Signs:
- Burton lines
(on gingivae & metaphysis of long bones)
- Basophilic stippling
- Encephalopathy
- Colic

25
Folate def megaloblastic anemia Pathology: Symptoms: Causes:
Folate deficiency results in high homocysteine levels resulting in folate levels (normal methylmalonic acid) Signs: - Hyper segmented PMN's - Glossitis - Hemolytic anemia Causes: - diet (no leafy greens) - chronic alcohol abuse - malabsorption - Pregnancy - drugs (methotrexate, trimethoprim, & phenytoin)
26
B12 deficiency megaloblastic anemia Pathology: Symptoms/Signs: Causes:
B12 deficiency causes megaloblastic anemia with high homocysteine and methylmalonic acid levels Signs: - Hyper segmented PMN's - Glossitis - Neurological symptoms - +ve Schillings test Causes: - Pernicious anemia - Malabsorption - Veganism (diet) - Pancreatic insufficiency - Gastrectomy - Tape worm
27
Orotic aciduria Pathology: Symptoms/Signs:
Path: UMP synthase deficiency that results in Orotic acid in the urine because it can't be converted to UMP Signs: - Developmental delay - No hyperammonemia - Glossitis - Megaloblastic anemia - Fait to thrive
28
Anemia: Hereditary spherocytosis Pathology: Signs: | "rbc's look like PEAS"
Path: AUTO DOM, defect in SPECTRIN & ankyrin, band 3, protein 4.2 Signs: - Extravascular hemolysis - Splenomegaly - Pigmented gallstones - Aplastic crisis Optional High MCHC High LDH High unconjugated bilirubin
29
G6PD deficiency Pathology: Symptoms/Signs: Causes:
Path: X-REC condition that results in autoimmune hemolytic anemia Signs: - Back pain - Hemoglobinuria (2-3 say post oxidative stress) - Heinze bodies - Bite cells - Blister cells Triggers: - FAVA beans - Sulfa drugs - Antimalaria
30
Paroxysmal nocturnal hemoglobinuria Pathology: Symptoms/Signs:
Path: Mutated PIGA (increases compliment mediated intravascular hemolysis) causes impaired GPI anchoring for CD55/59 resulting in hemolytic anemia Signs: - Pancytopenia - Venous thrombosis - Budd Chiari syndrome - Hemoglobinuria - Negative Coombs test - Negative CD55/59 on flow cytometry
31
Pyruvate kinase deficiency Pathology: Symptoms/Signs:
Path: Pyruvate kinase deficiency causes low ATP levels and rigid RBCs resulting in extravascular hemolysis & hemolytic anemia of a newborn Signs: Low Hb High 2,3 BPG Burr cells
32
Sickle cell disease Pathology: Symptoms/Signs:
Path: A point mutation to the 6th codon of B-globin gene to replace Glutamate with valine causing Sickling leading to intra/extra-vascular hemolysis Signs: Low HbA High HbF High HbS Sickled RBCs
33
HbC disease Pathology: Symptoms/Signs:
Path: A mutation in the 6th codon of B-globin to replace glutamate with lysine causing production of abnormal HbC & extravascular hemolysis Signs: Hemoglobin crystals in RBC's Target cells High HbC Low HbA
34
Anemia of chronic disease Pathology: Symptoms/Signs: Causes:
Path" Inflammatory mediators TNF & IL-6 cause liver to release more hepcidin to "hide" the body's iron (liver & macrophages) & reduce its absorption so iron chelators (inflammatory orgs or siderophores can't use it) Signs: Low iron Low TIBC High ferritin Normocytic Normochromic Triggers: - Chronic infection - Neoplastic disorders - Chronic kidney disease - Diseases like SLE or RA
35
Aplastic anemia Pathology: Symptoms/Signs: Causes:
Path: Failed or destroyed hematopoietic stem cells leading to hypocellular bone marrow with fat globules Signs: Low reticulocyte # High EPO Pancytopenia Fatigue/malaise Purpura Mucosal bleeding Petechiae Causes: - Fanconi anemia - Viruses (EBV mono, HIV, Hep A, B, C) -Benzene & Chloramphenicol
36
Autoimmune hemolytic anemia with warm Ab IgG Pathology: Symptoms/Signs: Causes:
Path: Chronic Normocytic/Normochromic anemia with extravascular hemolysis that can be triggered by SLE. Signs: Spherocytes Positive Coombs (Agglutinated RBCs) Formed IgG's vs RBCs Triggers: - SLE - a-methyldopa - B-lactams
37
Autoimmune hemolytic anemia with warm Ab IgM Pathology: Symptoms/Signs: Causes:
Path: Acute Normocytic & Normochromic hemolytic anemia with compliment fixation Signs: - RBC agglutination - Extravascular hemolysis during cold (toes, hands, ears) - Spherocytes - Positive Coombs (Agglutinated RBCs) - Formed IgM's vs RBCs Triggers: - Post mycoplasma pneumoniae & EBV (mono) infections
38
Coagulation disorders: Deficient factor VIII (8) Prolonged PTT Normal PT | "HESmophilia A"
Hemophilia A X REC Other signs - Soft tissue hematomas - Severe Hemarthropathy (blood in knee joint !) - Easy bruising
39
Coagulation disorders: Deficient factor IX (9) Prolonged PTT Normal PT
Hemophilia B X REC
40
Coagulation disorders: Deficient factor XI (11) Prolonged PTT Normal PT
Hemophilia C AUTO REC
41
Vitamins: Prolonged PT Prolonged PTT Normal bleeding time Deficient factors II(2), VII(7), IX (9), X (10), proteins C & S
Vitamin K deficiency
42
Bernard-Soulier syndrome Pathology: Symptoms/Signs:
Path: Aka giant platelet disorder, Def GPIb that results in giant platelets with poor adhesion & prolonging bleeding time Signs: - Menometrorrhagia - Mucus membrane bleeding - Petechia - Epistaxis - Gingival hemorrhages - Normal/low platelet # - Abnormal ristocetin test (no agglutination)
43
Glanzmann syndrome Pathology: Symptoms/Signs:
Glanzmann syndrome Deficient agglutination GPIIb/IIIa causing poor platelet plug formation (regardless of normal levels) this prolongs bleeding time Signs: - Petechiae (face) - Subconjunctival hemorrhages (crying) - Mucocutaneous & gingival hemorrhages - Epistaxis - Post circumcision bleeding
44
Immune Thrombocytopenia Pathology: Symptoms/Signs: | "igG's vs PlatElEts Makes Purpura"
Path: IgG Antibodies against GPIIb/IIIa cause destruction of platelets in the spleen (splenic macrophages) & can cross the placental if mom is preggos resulting in low platelet & CBC counts & prolonging bleed time Signs: - Purpura - Ecchymosis - Petechiae - Epistaxis - Menorrhagia - Gingival bleeding
45
Thrombotic Thrombocytopenic Purpura (TTP) Pathology: Symptoms/Signs: "Adam is MeATy & TPP"
PATH: Usually adult women Deficient ADAMTS13 (vWF metalloprotease) leads to a build up of vWF multimers which cleave RBC's resulting in more platelet adhesion/aggregation (despite low platelet counts) Signs: - Triad 1. Thrombocytopenia 2. Microangiopathic hemolytic anemia 3. Acute kidney injury - Fever - Neurological symptoms - Hemoglobinuria - Petechiae - Purpura - Mucosal bleeding 4. Low Haptoglobin & Schistocytes
46
Hemolytic uremic syndrome Pathology: Symptoms/Signs:
Path: Due to E.coli 0157:H7 Shiga toxin infection causing microangiopathic hemolytic anemia Sign: - Thrombocytopenia - Acute kidney injury - Normal PT & PTT
47
Von Willebrand Disease Pathology: Symptoms/Signs:
PATH: AUTO DOM Intrinsic path coagulation deficiency in vWF causing increase in bleeding time & poor platelet plug Signs: Low vWF No aggregation with ristocetin factor (agglutination with added vWF) Normal platelet levels but prolonged bleeding time
48
Deficient vWF protein/function & factor VIII
Type 1 vWF
49
Normal vWF levels with missense mutations causing multimers leads to microangiopathic hemolytic anemia
vWF Type 2
50
Disseminated Intravascular Coagulation Pathology: Symptoms/Signs:
Path: Deficient widespread clotting activation leads to a deficiency in clotting factors Signs: Prolonged Bleeding time High PTT & PT Low platelet # Low fibrinogen Low factors V & VIII Schistocytes
51
Antithrombin deficiency Pathology: Symptoms/Signs:
Path: Acquired from renal failure or nephrotic syndrome as the Antithrombin is lost in the urine leading to less inhibition of coagulation factors IIa & Xa Signs: Normal PT Normal PTT (**Decreased PTT with large dose of heparin**) Renal failure
52
Factor V Leiden Pathology: Symptoms/Signs:
Path: Mutated factor V in prothrombin gene that swaps glutamine with arginine so factor V becomes more resistant to protein C cleavage Signs: - DVTs - Cerebral vein thrombosis - Recurrent abortions - Increased prothrombin levels
53
Prothrombin gene mutation (or Factor II mutation) Pathology: Symptoms/Signs:
Path: Prothrombin G20210A point mutation in the 3' untranslated region causing an increase in prothrombin production leading to a hypercoagulable state Signs: High prothrombin High plasma volume High venous clot formation

USMLE Pathoma (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions