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Hematological Disease > Anemias > Flashcards

Anemias Flashcards

1
Q

Name the 3 types of Anemias and their corresponding MCVs

A

Microcytic (MCV < 80)
Normocytic (80-100)
Macrocytic (100+)

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2
Q

Name 5 categories of Microcytic Anemias

A 
Iron deficiency anemia
Anemia of Chronic disease
Thalassemia
Sideroblastic Anemia
Lead Poisoning
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3
Q

Describe peripheral stain and blood work for microcytic anemias

A

PS: Hypochromic, microcytic

Decreased Hb + Increased mitosis

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4
Q

Microcytic anemias all involve decreased _____ synthesis

A

Hb

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5
Q

Normal Hb synthesis requires ___, _____ and ____.

A

Normal Hb synthesis requires iron, porphyrin ring and globin.

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6
Q

Microcytic Anemias > what are the missing Hb components for each of the microcytic anemias?

A

Iron Def/ACD - no Iron
Thalassemia - no globin
Sideroblastic/Lead - no porphyrin

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7
Q

Iron Deficiency Anemia (Etiology)

A 
No iron for Hg Synthesis
Clinical causes:
- Malabsorption (duodenum)
- GI bleeding (Meckel's in neonates)
- Hookworm
- Blood donations
- pica
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8
Q

Iron Deficiency Anemia (Pathogenesis)

A

Iron is brought via transferrin to immature RBC for insertion into porphyrin ring
– Malabsorption of iron (heme - ferrous HCP1, non-heme-ferric, DMT both in duodenum) is another common cause

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9
Q

Iron Deficiency Anemia (Buzz words)

A

GI bleed
Hypochromic/Microcytic
Koilonychia

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10
Q

Iron Deficiency Anemia (Presentation)

A 
Green pallor
Dizziness
Breathlessness
Glossitis
Koilonychia
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11
Q

Iron Deficiency Anemia (Peripheral smear)

A

Microcytic, hypochromic

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12
Q

Iron Deficiency Anemia (Iron studies)

A

Low serum iron
Low Ferritin
High TIBC/transferrin binding
Low iron saturation

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13
Q

Iron Deficiency Anemia (Treatment)

A 
Ferrous sulfate (oral)
Iron Dextran (IV)
*Iron overload treatment --> deforoxamine (IV), deferasirox (oral + OJ)
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14
Q

Anemia of Chronic Disease (Etiology)

A

ACD is evolved “protection”. Inflammation commonly caused by microbials requiring iron for survival. Body sequeters iron inside bone marrow macrophages and enterocytes.

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15
Q

Anemia of Chronic Disease (Pathogenesis)

A

Body sequesters iron&raquo_space; no free iron for Hg synthesis

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16
Q

Anemia of Chronic Disease (Buzz words)

A

Chronic disease&raquo_space; inflammation&raquo_space; IL-6&raquo_space; Hepcidin&raquo_space; decreased release of iron

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17
Q

Anemia of Chronic Disease (Presentation)

A

Concurrent disease ie. AIDS, TB, Rheumatoid arthritis, cancer

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18
Q

Anemia of Chronic Disease (Peripheral smear)

A

Bone marrow stained w/ prussian blue shows iron inside BM macrophages

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19
Q

Anemia of Chronic Disease (Iron studies)

A

Low serum iron
High ferritin
High TIBC/tranferrin binding
Low transferrin in serum

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20
Q

Sideroblastic Anemia (Etiology)

A

Iron is trapped inside of mitochondria = “Ringed Sideroblasts”
Defective porphyrin ring synthesis

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21
Q

Sideroblastic Anemia (Associated Diseases & mechanism)

A

Alcoholics - poison mitochondria
B6 deficiency (cofactor for ALA dehydrase)
Lead (inhibits ferrocheletase)

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22
Q

Sideroblastic Anemia (Buzz words)

A

Alcoholics
Vitamin B6
Ringed sideroblasts

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23
Q

Sideroblastic Anemia (Presentation)

A

Alcoholic
B6 deficient
Lead poison

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24
Q

Sideroblastic Anemia (Peripheral smear)

A

Ringed sideroblasts

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25
Q

Sideroblastic Anemia (Iron studies)

A 
Serum raised iron
ferritin raised (iron overload problem)
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26
Q

Sideroblastic Anemia (Treatment)

A

Treat underlying disease (eg. Pyridoxine B6)

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27
Q

Alpha Thalassemia (Etiology)

A

Whole gene deletion on ch. 16

Beta hemochromes cause membrane damage&raquo_space; RBC intravascular hemolysis

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28
Q

Alpha Thalassemia (Describe 5 subtypes and severity of each)

A

5 Possible Mutations (4 alpha genes/cell)

  1. Silent Alpha Thalassemia
    - – 1 gene deletion (asymptomatic)
  2. Alpha Thalassemia Trait
    - –2 gene deletions (mild anemia)
  3. HbH
    - – 3 gene deletions (hypersplenism, gallstones, leg ulcers)
  4. Hg Bart’s
    - - 4 gene deletions (hydrops fetals at 30-40 wks)
  5. Hg Constant Spring
    - – single base mutation in stop codon causing unstable mRNA&raquo_space; no translation of alpha globin
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29
Q

Alpha Thalassemia (Buzz words)

A

HgH
HgBart’s
Chr. 16
Target cells

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30
Q

Alpha Thalassemia (Presentation)

A

Asian/black population

no “hair on end” because this is intravascular hemolysis

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31
Q

Alpha Thalassemia (Diagnostic technique)

A

Hg Electrophoresis and PCR (PCR because alpha globin is in every Hg type)

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32
Q

Alpha Thalassemia (CBC)

A

RBC count will be normal

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33
Q

Alpha Thalassemia (Peripheral smear)

A

TARGET CELLS

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34
Q

Alpha Thalassemia (Iron studies)

A

Normal

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35
Q

Alpha Thalassemia (Treat)

A

Blood transfusions
Cure w/ allogenic transplant
**Do NOT treat with iron

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36
Q

What type of anemia are TARGET CELLS found and what disease do they protect against?

A

Alpha & Beta Thalassemia, malaria

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37
Q

Beta Thalassemia (Etiology)

A

Point mutation in beta globin on Ch. 11

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38
Q

Beta Thalassemia (Mechanism)

A

Decreased beta chain&raquo_space; excess alpha globin > alpha hemochromes cause RBC hemolysis (membrane damage) in BM > ineffective erythropoiesis = HAIR ON END BM expansion

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39
Q

Beta Thalassemia (Describe 4 subtypes and gene products)

A
  1. Beta thalassemia trait
    - – 1 abnormal gene > underproduction of Beta globin (B+) > mild anema > lots of HbA2
  2. Beta thalassemia major
    - – both genes abnormal > severe anemia
  3. Hg Lapore
    - – Fused beta/delta gene underproduced beta > relative increase in alpha > Thalassemia intermedia
  4. Hereditary Persistence of fetal Hb
    - – co-deletion of beta/delta > all HbF
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40
Q

Beta Thalassemia (Buzz words)

A

Hair on end
Ch. 11
Target cells

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41
Q

Beta Thalassemia (Presentation)

A 
Mediterranean/Black
Hair on end
Chipmunk face
* Hypercoagulation: membrane damage exposes p-serine = thrombogenic
*Endocrinopathies
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42
Q

Beta Thalassemia (Peripheral smear)

A

Target cells

Basophilic stipplin

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43
Q

Beta Thalassemia (CBC/Iron studies)

A

Normal RBC count and feritin

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44
Q

Beta Thalassemia (Treatment)

A

Blood transfusions

Cure w/ transplant

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45
Q

Beta Thalassemia (Diagnostic method)

A

Hg Electrophoresis

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46
Q

Lead Poisoning (Mechanism)

A

Lead Inhibits Key enzymes:
»Lead inhibits ferrocheletase (inserts Fe into protoporphyrin), ALA dehydrase and ribonuclease (RNA destruction)&raquo_space;ringed sideroblasts and basophilic stippling

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47
Q

Lead Poisoning (Buzz words)

A

Basophilic stippling, paint chips, battery

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48
Q

Lead Poisoning (Presentation)

A

Automechanic, pottery, paint chipping, moonshine

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49
Q

Lead Poisoning (Peripheral smear)

A

Ringed sideroblasts

Basophilic stippling

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50
Q

Lead Poisoning (Fe studies)

A

Increased ferritin

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51
Q

Compare MCV values for:

  1. Iron-deficiency anemia
  2. Anemia of Chronic disease
  3. Thalassemia train (alpha or beta)
  4. Sideroblastic anemia
A
  1. Reduced
  2. Low normal or normal
  3. Very low for degree of anemia
  4. Low in inherited type but often raised in acquired type
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52
Q

Compare Serum iron values for:

  1. Iron-deficiency anemia
  2. Anemia of Chronic disease
  3. Thalassemia train (alpha or beta)
  4. Sideroblastic anemia
A
  1. Reduced
  2. Reduced
  3. Normal
  4. Raised
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53
Q

Compare Serum TIBC values for:

  1. Iron-deficiency anemia
  2. Anemia of Chronic disease
  3. Thalassemia train (alpha or beta)
  4. Sideroblastic anemia
A
  1. Raised
  2. Reduced
  3. Normal
  4. Normal
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54
Q

Compare Serum Ferritin values for:

  1. Iron-deficiency anemia
  2. Anemia of Chronic disease
  3. Thalassemia train (alpha or beta)
  4. Sideroblastic anemia
A
  1. Reduced
  2. Normal or raised
  3. Normal
  4. Raised
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55
Q

Compare Serum soluble transfer receptor values for:

  1. Iron-deficiency anemia
  2. Anemia of Chronic disease
  3. Thalassemia train (alpha or beta)
  4. Sideroblastic anemia
A
  1. Increased
  2. Normal
  3. Normal or raised
  4. Normal or raised
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56
Q

Name 2 major and 2 subgroups of Normocytic (80-100) anemias

A
  1. Non-Hemolytic (Normal/Low Retic)
  2. Hemolytic (High Retic)
    a. Intrinsic
    b. Extrinsic
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57
Q

Name 2 subgroups of Non-Hemolytic Normocytic anemias

A

ACD
Aplastic Anemia
Kidney disease

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58
Q

Name 5 subgroups of Intrinsic Hemolytic normocytic anemias

A 
Hereditary spherocytosis
Enzyme deficiencies
HbC
Sickle cell disease
PNH
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59
Q

Name 5 subgroups of Extrinsic Hemolytic normocytic anemias

A 
Autoimmune 
MAHA (heart valve)
MIAHA
Infections Disease
Blood Transfusion
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60
Q

Reticulocyte count is important in the classification of which type of anemia?

A

Normocytic anemias

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61
Q

What does reticulocyte count tell you about the bone marrow?

A

RC tells you if BM is able to compensate for anemia

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62
Q

How long does it take for reticulocyte count deficiencies to show up/ be detectable?

A

5 - 7 days

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63
Q

How do you calculate the corrected reticulocyte count?

A

(Hct/45)*Retic = corrected Retic

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64
Q

How do you modify the corrected Retic equation if there are polychromic cells in PS?

A

Divide by 2

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65
Q

Normal Reticulocyte count > Anemia of chronic disease (what is the clinical relevance of this type of anemia?)

A

Associate with malignancies&raquo_space; also, may present as microcytic anemia

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66
Q

Normal Reticulocyte count > Aplastic Anemia (Possible etiologies?)

A

Idiopathic
chemicals
Infection (Parvovirus)
Radiation

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67
Q

Normal Reticulocyte count > Aplastic Anemia (Buzz words)

A 
Chloramphenicol
HIV
ECV
Parvovirus
Idiopathic
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68
Q

Normal Reticulocyte count > Aplastic Anemia (CBC)

A

PANCYTOPENIA

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69
Q

Normal Reticulocyte count > Aplastic Anemia (PS)

A

Acellular bone marrow

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70
Q

Normal Reticulocyte count > Chronic renal failure (Mechanism)

A

Decreased erythropoietin > decreased hematopoiesis

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71
Q

Normal Reticulocyte count > Chronic renal failure (Buzz words)

A

Chronic renal failure

Disease

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72
Q

Normal Reticulocyte count > Chronic renal failure (Presentation)

A

Concurrent CRF

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73
Q

Normal Reticulocyte count > Chronic renal failure (PS)

A

Burr Cells

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74
Q

Normal Reticulocyte count > Chronic renal failure (Treatment)

A

Epoetin Alpha
Darbepoetin
Methoxy-PEG-epoetin beta

75
Q

High Reticulocyte Count (>3%) (Hemolytic Anemia - Intrinsic)&raquo_space; Hereditary spherocytosis (Etiology)

A

Defect in RBC membrane protein band3, spectrin, ankryin > TOO LITTLE MEMBRANE

76
Q

High Reticulocyte Count (>3%) (Hemolytic Anemia - Intrinsic)&raquo_space; Hereditary spherocytosis (Buzz words)

A 
Spherocytes
Osmotic fragility
Splenomegaly
Asplenia
Howell Jolly bodies
77
Q

Hereditary spherocytosis (Presentation)

A

Splenomegaly due to premature removal of RBC by spleen

78
Q

Hereditary spherocytosis (Peripheral smear)

A

Spherocytes, Howell-Jolly bodies

79
Q

Hereditary spherocytosis (Diagnosis)

A

Positive osmotic fragility test

80
Q

Hereditary spherocytosis (Treatment)

A

Splenectomy

81
Q

G6PD Deficiency (Mechanism)

A

G6PD deficiency: No NADPH for preventing Hb–>Methamoglobin and for preventing spectrin cross linking.

82
Q

G6PD Deficiency (Buzz words)

A 
FAVA beans
Heinz bodies
Bite cells
Apple core cell
X-linked
83
Q

G6PD Deficiency (Presentation)

A

x-linked

84
Q

G6PD Deficiency (Peripheral smear)

A

Heinz bodies
Bite cells
* Heinz bodies result from Hb (ferrous) > Mb (ferric) > denatured Hb > ppt in membrane

85
Q

G6PD Deficiency (Diagnosis)

A

Enzyme activity; wait to test

86
Q

Pyruvate Kinase Deficiency (Mechanism)

A

Decreased ATP production causes:

  1. No energy for RBC membrane maintenance > Rigid RBC
  2. No Na/K pump > H2O lysis cell
87
Q

Pyruvate Kinase Deficiency (Buzz words)

A

Pyruvate kinase
ATP
Autosomal recessive

88
Q

Name the disease associated with the Buzz words:

  • Pyruvate kinase
  • ATP
  • Autosomal recessive
A

Pyruvate Kinase Deficiency

89
Q 
Name the disease associated with the Buzz words:
FAVA beans
Heinz bodies
Bite cells
Apple core cell
X-linked
A

G6PD Deficiency

90
Q 
Name the disease associated with the Buzz words:
Spherocytes
Osmotic fragility
Splenomegaly
Asplenia
Howell Jolly bodies
A

Hereditary Spherocytosis

91
Q 
Name the disease associated with the Buzz words:
Chloramphenicol
HIV
ECV
Parvovirus
Idiopathic
A

Aplastic Anemia

92
Q

Name the disease associated with the Buzz words:
Hair on end
Ch. 11
Target cells

A

Beta Thalassemia

93
Q

Name the disease associated with the Buzz words:

Basophilic stippling, paint chips, battery

A

Lead poisoning

94
Q

Name the disease associated with the Buzz words:
Alcoholics
Vitamin B6
Ringed sideroblasts

A

Sideroblastic anemia

95
Q

Name the disease associated with the Buzz words:
GI bleed
Hypochromic/Microcytic
Koilonychia

A

Iron Deficiency Anemia

96
Q 
Name the disease associated with the Buzz words:
Chronic disease
inflammation
IL-6 
Hepcidin
Decreased release of iron
A

Anemia of Chronic Disease

97
Q 
Name the disease associated with the Buzz words:
HgH
HgBart's
Chr. 16
Target cells
A

Alpha Thalassemia

98
Q

Pyruvate Kinase Deficiency (Presentation)

A

Autosomal Recessive

99
Q

Pyruvate Kinase Deficiency (Peripheral smear)

A

Polychromasia

General findings of anemia

100
Q

Pyruvate Kinase Deficiency (Diagnosis)

A

Enzymatic enzyme activity test

101
Q

Paroxysmal Nocturnal Hemoglobinuria (Etiology)

A

Defective pig-A gene

102
Q

Paroxysmal Nocturnal Hemoglobinuria (Mechanism)

A

Defective pig-A gene > defective GPI anchor for DAF/CD59> increased complement lysis of RBC

103
Q

Paroxysmal Nocturnal Hemoglobinuria (Buzz words)

A

pig-A
DAF
CD59
Thrombosis

104
Q 
Name the disease associated with the Buzz words:
pig-A
DAF
CD59
Thrombosis
A

Paroxysmal Nocturnal Hemoglobinuria

105
Q

Paroxysmal Nocturnal Hemoglobinuria (Presentation)

A

Intermittent hemolysis in adults

Associated thrombosis

106
Q

Paroxysmal Nocturnal Hemoglobinuria (Peripheral smear)

A

Normal

107
Q

Paroxysmal Nocturnal Hemoglobinuria (DDx)

A

Urine hemosiderin + flow cytometry

108
Q

Paroxysmal Nocturnal Hemoglobinuria (Treatment)

A

mAb xComplement

109
Q

Sickle Cell Disease (HbS) – Etiology

A

Base change in AA#6: Glu&raquo_space; Val (GAG-GTG)» HbS/HbSS

110
Q

Sickle Cell Disease (HbS) – Mechanism

A

In Deoxygenated state:
Hydrophobic valine cross-links/RBC polymerizes&raquo_space; vaso-occlusion + hemolysis of RBC&raquo_space; anemia + NO scavenger (free Hb) + reperfusion injury

111
Q

Sickle Cell Disease (HbS) – Is instigated by which conditions/diseases?

A 
Hypoxia 
Anemia
Cold
Acidosis
Dehydration
112
Q 
Name the disease associated with the Buzz words:
African American
Deoxygenated Hg
Dactylitis
Hydroxyurea
Autosomal recessive
A

Sickle Cell Disease (HbS)

113
Q

Sickle Cell Disease (HbS) – Presentation

A 
AR
Initially symptomatic newborns because HbF is protective
Dactylitis (children)
Pain
Leg ulcers
Asplenia (Howell Jolley Bodies)
114
Q

Sickle Cell Disease (HbS) – Peripheral smear

A

Sickle cell

Target cell

115
Q

Sickle Cell Disease (HbS) – Diagnosis

A

Hg Electrophoresis

Low Hg

116
Q

Sickle Cell Disease (HbS) – Treatment

A

Hydroxyurea (increase HbF&raquo_space; binds hydrophobic valine)

Bone Marrow transplant

117
Q

Microangiopathic and Macroangiopathic Hemolytic Anemia (Mechanism)

A

RBCs are damaged when passing through obstructed vessel lumen (micro) or via mechanical damage (macro)

118
Q

Microangiopathic and Macroangiopathic Hemolytic Anemia (Buzz words)

A 
Disseminated intravascular coagulation (DIC)
TTP
SLE
Malignant hypertension
Schistocytes
Helmet cells
119
Q

Microangiopathic and Macroangiopathic Hemolytic Anemia (Presentation)

A

Dysfunctional calcified aortic valve/march, running (macro)

120
Q

Microangiopathic and Macroangiopathic Hemolytic Anemia (Associated diseases)

A

DIC
TTP
SLE

121
Q

Microangiopathic and Macroangiopathic Hemolytic Anemia (Peripheral smear)

A

Schistocytes

Helmet cells

122
Q

Name the disease associated with the Buzz words:
Disseminated intravascular coagulation (DIC)
TTP
SLE
Malignant hypertension
Schistocytes
Helmet cells

A

Microangiopathic and Macroangiopathic Hemolytic Anemia

123
Q

Warm Autoimmune Hemolytic Anemia (IgG) – Buzz words

A 
IgG
RES
Coomb's
Erythroblastosis fetalis
SLE
Penicillin
Methyldopa
Microspherocytes
Jaundice
124
Q 
Name the disease associated with the Buzz words:
IgG
RES
Coomb's
Erythroblastosis fetalis
SLE
Penicillin
Methyldopa
Microspherocytes
Jaundice
A

Warm Autoimmune Hemolytic Anemia (IgG) – Buzz words

125
Q

Warm Autoimmune Hemolytic Anemia (IgG) – Mechanism

A

IgG targeted at RBC > direct phagocytosis or complement-mediated > Extravascular ((RES in spleen) or intravascular (complement) lysis

126
Q

Warm Autoimmune Hemolytic Anemia (IgG) – Presentation

A

Occurs in newborns due to RhD incompatibility
seen w/SLE or with Rx (methyldopa, penicillin, quinidine)
pt. will have mild icterus, jaundice symptoms

127
Q

Warm Autoimmune Hemolytic Anemia (IgG) – Peripheral smear

A

Microspherocytes (partial phagocytosis from RES)

128
Q

Warm Autoimmune Hemolytic Anemia (IgG) – Diagnosis

A

Coomb’s + Direct Ab

129
Q

Warm Autoimmune Hemolytic Anemia (IgG) – Treatment

A 
Steroids
Rituximab
Splenectomy
Azathioprine
Blood transf.
130
Q

Cold autoimmune Hemolytic Anemia (IgM) – Mechanism

A

IgM targeted RBC > COMPLEMENT MAC ONLY > Intravascular hemolysis > Hemoglobinuria

131
Q

Cold autoimmune Hemolytic Anemia (IgM) – Presentation

A

Occurs at low temps
Common in patients with mycoplasma
EBV
Cytomegalovirus

132
Q

Cold autoimmune Hemolytic Anemia (IgM) – Peripheral blood

A

Aggregates of RBC

133
Q

Cold autoimmune Hemolytic Anemia (IgM) – Labs

A

Hemoglobinuria
Low haptoglobin
*Not as much jaundice because free unconjugated bilirubin is bound quickly by haptoglobin (intravascular hemolysis)

134
Q

Cold autoimmune Hemolytic Anemia (IgM) – Diagnosis

A

Direct Ab test

Coomb’s+ for Ab

135
Q

Cold autoimmune Hemolytic Anemia (IgM) – Buzz words

A 
IgM
Complement-mediated
Low haptoglobin
Hemoglobinuria
Mycoplasma
EBV
CMV
Raynaud's Phenomenon
136
Q 
Name the disease associated with the Buzz words:
IgM
Complement-mediated
Low haptoglobin
Hemoglobinuria
Mycoplasma
EBV
CMV
Raynaud's Phenomenon
A

Cold autoimmune Hemolytic Anemia (IgM) – Buzz words

137
Q

Thrombotic Thrombocytopenia Purpura (TTP) – Mechanism

A

AutoAb at AdamTS13 an enzyme cleaving vWF > long vWF > cleaves RBC > schistocytes

138
Q

Thrombotic Thrombocytopenia Purpura (TTP) – Presentation

A

Thrombosis
Hemorrhaging
Bruising

139
Q

Thrombotic Thrombocytopenia Purpura (TTP) – Labs

A

Thrombocytopenia

MAHA

140
Q

Thrombotic Thrombocytopenia Purpura (TTP) – Peripheral smear

A

Schistocytes

Helmet cells

141
Q

Thrombotic Thrombocytopenia Purpura (TTP) – Treatment

A

Plasmaphoresis to xAb

142
Q

Thrombotic Thrombocytopenia Purpura (TTP) – Buzz words

A

Thrombocytopenia
MAHA
Schistocytes
vWF

143
Q 
Name the disease associated with the Buzz words:
Thrombocytopenia
MAHA
Schistocytes
vWF
A

Thrombotic Thrombocytopenia Purpura (TTP)

144
Q

Malaria (Mechanism)

A

Mosquito vector infects RBC w/ protozoal species

Plasmodium falciparum is most lethal

145
Q

Malaria (Presentation)

A

Traveler to 3rd world country
Tropical/subtropical
Symptomatic

146
Q

Malaria (Peripheral smear)

A

Merozites

Gametocytes

147
Q

Malaria (Buzz words)

A

Third world
Tropical
Plasmodium falciparum

148
Q

Name the disease associated with the Buzz words:
Third world
Tropical
Plasmodium falciparum

A

Malaria

149
Q

Babesia (Mechanism)

A

Infected w/intracellular protozoal parasite from tick bite

150
Q

Babesia (Presentation)

A

Traveler to US northeast

Tick bite

151
Q

Babesia (Peripheral smear)

A

Intracellular parasite

152
Q

Babesia (Buzz words)

A

US northeast

Tick bite

153
Q

Name the disease associated with the Buzz words:
US northeast
Tick bite

A

Babesia

154
Q

Bartonella Bacilliformis (mechanism)

A

Sand flies transmit intracellular parasite

155
Q

Bartonella Bacilliformis (Presentation)

A

Traveler to north andes, peru
Acute presentation&raquo_space; anemia
Chronic presentation&raquo_space; peruvian warts
Splenomegaly

156
Q

Bartonella Bacilliformis (Peripheral smear)

A

Basophilic intracellular parasite

157
Q

Bartonella Bacilliformis (Treatment)

A

Antibiotics

158
Q

Bartonella Bacilliformis (Buzz words)

A

North Andes
Peruvian warts
Sand flies

159
Q

Name the disease associated with the Buzz words:
North Andes
Peruvian warts
Sand flies

A

Bartonella Bacilliformis infection

160
Q

C. Perfringens (Mechanism)

A

Normal component of skin flora causes sepsis and gas gangrene

161
Q

C. Perfringens (Presentation)

A

Complication of cholecystitis
Septic abortion
Trauma

162
Q

C. Perfringens (Peripheral smear)

A

Accumulation of microspherocytes

No Hg in cells&raquo_space; Hg shadow

163
Q

C. Perfringens (Buzz words)

A

Normal flora
Cholecystitis
Septic Abortion

164
Q

Name the disease associated with the Buzz words:
Normal flora
Cholecystitis
Septic Abortion

A

C. Perfringens infection

165
Q

Folate Deficiency (Mechanism)

A

Folate is required in reduction of homocysteine > methionine; 1 carbon transfer reaction needed to (eventually) convert dUMP&raquo_space; dTMP in DNA synthesis

166
Q

Folate ingestion and absorption forms

A

Ingested as polyglutamate

Absorbed/functions at monoglutamate

167
Q 
Name the disease associated with the Buzz words:
Green leafy vegetables
Fortified cereals
Neural tube
Spina bifida
Megaloblastic anemia
Methotrexate
Hypersegmented neutrophils
A

Folate Deficiency

168
Q

Folate Deficiency (Presentation)

A

Pregnant women
Elderly
Poor
Alcoholics

169
Q

Folate Deficiency (Lab tests)

A

Serum folate
Increased homocysteine
*Increased homocysteine causes MI and thrombosis

170
Q

Folate Deficiency (Peripheral smear)

A

Megaloblasts (mature cytoplasm, immature large nucleus) + hypersegmented polys

171
Q

Folate Deficiency (Treatment)

A

Folic acid
Leucovorin
Levomofolate
*Methotrexate, trimethoprim, pyrimethamine, phenoytin cause folate deficiency

172
Q

Folate Deficiency (Buzz words)

A 
Green leafy vegetables
Fortified cereals
Neural tube
Spina bifida
Megaloblastic anemia
Methotrexate
Hypersegmented neutrophils
173
Q

B12 Deficiency (Main problem)

A

No DNA synthesis or Odd Chain Fatty Acid Metabolism

174
Q

Main problem with Folate Deficiency

A

No DNA synthesis

175
Q

B12 Deficiency (Mechanism)

A

B12 is required for homocysteine > methionine (dUMP&raquo_space; dTMP) Odd chain fatty acid

176
Q

B12 Deficiency (Absorption)

A

Distal ileum > binds to R-binder > then IF

177
Q

B12 Deficiency (Main causes)

A

Decreased B12 intake
Malabsorption
Pancreatic insufficiency

178
Q

B12 Deficiency (Presentation)

A

Elderly
Pernicious anemia
*PA is gastric atrophy (loss of IF) due to CD4+ recognition of ATPase, Anti-IF Ab, or Anti-Parietal cell antibodies

179
Q

B12 Deficiency (Peripheral smear)

A

Megaloblasts

Hypersegmented polys

180
Q

B12 Deficiency (Test)

A

Serum B12

MMA Levels

181
Q

B12 Deficiency (Treatment)

A

Cyanocobalamin

Hydroxocobalamin

182
Q

Folate Deficiency vs. B12 Deficiency

A

B12 deficiency causes neurological syndromes & Folate deficiency does not

183
Q

B12 Deficiency (Buzz words)

A 
Meat 
Milk
Cheese
Vegan
IF
R-binder
Pernicious anemia
Zollinger Ellison Syndrome
Diphyllobothrium Latum
Crohn's Disease
184
Q 
Name the disease associated with the Buzz words:
Meat 
Milk
Cheese
Vegan
IF
R-binder
Pernicious anemia
Zollinger Ellison Syndrome
Diphyllobothrium Latum
Crohn's Disease
A

B12 Deficiency

Hematological Disease (3 decks)

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