Blood and Immunology Flashcards
DDx microcytic anemia (3)
- Iron deficiency, 2. Thalassemia, 3. Chronic inflammation
Normocytic anemia DDx
Blood loss, immune hemolytic, spherocytosis, sickle cell, renal disease
Macrocytic anemia DDx
Folate def, B12 def, liver disease, hypothyroid, neoplasms, aplastic anemia,
Risk factors for Hodgkin lymphoma
EBV, immunosupression/HIV, autoimmune diseases
signs of acute hemolytic transfusion reaction
Fever, hemoglobinuria, hypotension, DIV, evidence of hemolysis, complement activation
Signs of hemolysis on labs
Low haptoglobin and high LDH
Delayed hemolytic transfusion reaction causes hemolysis where?
Extravascular hemolysis in the reticuloendothelial system (spleen)
Reticuloendothelial system organ is
Spleen
Preventing hemolytic disease of the fetus
Give rh immune globulin to d negative moms before they form antibodies
Neonatal Alloimmune thrombocytopenia mechanism
Antibodies vs platelet antigens in fetus leading to severe bleeding complications at time of delivery
Transfusion related acute lung injury (TRALI)
Antibody mediated reaction from donor units that activate neutrophils in the recipient causing inflammatory damage to the lungs
Transfuse if Hgb is less than
70
How many platelets in a donor pack
30x10^10
Shelf life of platelets
7 days
Female donor plasma is used to make
Albumin and IvIg
Male plasma is used for
Transfusion, cryosupernatant, cryoprecipitate
INR threshold for transfusion
INR 1.6
Immune mediated transfusion complications
Hemolytic, febrile/allergic, TRALI, PTP, TA-GVHD, alloimmunization
Non immune mediated hazards of transfusion
Sepsis, non-immune hemolysis, mistransfusion, TACO, coagulopathic complications, iron overload
Pattern recognition receptors are a component of which immune system
Innate immune system
B and T cells are associated with which type of immunity
Adaptive
Antigen receptor type on B cells
Ig
Central tolerance immune system happens in
Thymus and bone marrow
Autoantibodies associated with rheumatoid arthritis
Rheumatoid factor, antibodies against citrullinated protein antigens (ACPA)
MHC presents the antigen to
T cell receptors
CD28 is located in
The T cell
HLA-B27 is associated with
Ankylosing spondylitis
Kawasaki disease is a
Medium vessel vasculitis affecting children
In SLE, autoantibodies are to
The cell nucleus
SLE arthritis is
Non erosive in a distribution like rheumatoid arthritis
SLE manifestations (renal)
Lupus nephritis: persistent proteinuria, cell casts, hematuria, pyuria, hypertension, increased creatinine
CNS manifestations neurologic
Stroke, vasculitis, seizures, psychosis
Hematologic disorders of SLE
Hemolytic anemia, leukopenia, thrombocytopenia
Autoantibodies specific to SLE
Anti-dsDNA
ANA+ in what % of SLE cases
> 95%
The presentation of SLE is
Heterogenous - some kind of antibodies, and inflammation
Drug classes used to treat SLE include
Antimalarials, corticosteroids, immunosuppressants, and biologicals
SLE stands for
Systemic lupus erythematosus
Type I hypersensitivity is how fast?
Immediate
Type I hypersensitivity mediated with Ig…what?
IgE
Allergic reactions are usually which type of hypersensitity
Type I, IgE mediated q
Type II hypersensitivity involves which Ig?
IgM or IgG
Thrombocytopenia and hemolytic anemia are which type of hypersensitivity
Type II