Blood and Lymphatic Disorders Flashcards
Microcytic, developing countries ( reduced intake), developed countries (blood loss, G.I. or menstruation), pica, fingernail spooning
Iron deficiency anemia
Microcytic, common among hospitalized, chronic/systemic inflammation suppresses erythropoiesis
Anemia of chronic disease
Microcytic, unstable RBCs cause hemolysis, β-thalassemia is much more severe, skeletal deformation, hair-on-end skull
Thalassemia (α and β)
Microcytic, interferences with enzymes for heme synthesis, which impairs the ability to incorporate iron into heme, basophilic stippling
Lead poisoning
Macrocytic (megaloblastic), associated with gastric atrophy or malabsorption, elderly, fatigue, weakness, neuropathies (distinguish from folate deficiency anemia
Vitamin B12 deficiency anemia (pernicious anemia)
Macrocytic (megaloblastic), poor diet (processed), fatigue, weakness, sore tongue
Folate deficiency anemia
Normocytic, hemorrhage, burns, G.I. bleed, bloody diarrhea
Acute blood loss
Normocytic, RBC membrane mutations, causes spherical RBCs, cells look dark on peripheral smear, splenectomy is common treatment
Hereditary spherocytosis
Normocytic, myeloid stem cells are suppressed, T cells attack marrow, failure to produce RBCs, granulocytes, platelets, commonly idiopathic, splenomegaly is characteristically absent, petechiae (loss of platelets)
Aplastic anemia
Normocytic, RBCs are sensitive to complement-mediated hemolysis, sleeping causes reduced pH, complement is slightly activated, wake with hemoglobinuria in morning (paroxysmal)
Paroxysmal nocturnal hemoglobinuria
Normocytic, β-globin mutation, microvascular thrombosis (crisis), acute chest syndrome, stroke, African Americans, stunted growth
Sickle cell anemia
X-linked disorder of deficient G6PD, failure to protect RBCs against oxidation (infection, NSAIDs), Heinz bodies, bite cells, 3 day lag period
Glucose-6-phosphate dehydrogenase (G6PD) deficiency
Warm antibody: active around body temperature, IgG opsonization. Cold antibody: active around 85 degrees F, IgM opsonization. Drug induced
Immune hemolytic anemia
Plasmodium falciparum (Anopheles mosquito), Africa and SE Asia, lethal, intravascular hemolysis, merozoite showers, fever, splenomegaly, may cause CNS or renal damage
Malaria
increased RBC mass
- Relative: dehydration
- Absolute: reaction to elevated erythropoietin (hypoxia)
Polycythemia
increased RBC mass due to autonomous production, normal erythropoietin, chronic myeloproliferative disorder, hypercellular marrow, overexpression of myeloid stem cell, JAK2 gene mutation, hepatosplenomegaly, thrombosis, headache, vertigo, stroke, pruritus after bathing
Polycythemia vera
WBC disorder, Infectious mononucleosis
Epstein-Barr virus (EBV), fever, pharyngitis, lymphadenitis, Monospot test for atypical lymphocytes
WBC disorder, Bartonella henselae, most common among pediatrics
Cat-scratch disease
B cells, predictable metastasis, Reed-Sternberg cells, painless lymphadenopathy, night sweats, cachexia, anemia, pruritis, history of EBV infection or Agent Orange exposure
Hodgkin lymphoma
Non-hodkin, aggressive, rapid onset, T or B cells, children
Acute lymphoblastic leukemia
Non-hodkin, B cells, insidious, most common leukemia of adulthood, pancytopenia, infections, anemia
Chronic lymphocytic leukemia
Non-hodkin, B cells, variable aggressiveness, most over 50 years old, lymph nodes have a nodular (follicular) appearance
Follicular lymphoma
Non-hodkin, B cells, most common lymphoma of adulthood, fatal if untreated, responds well to chemotherapy
Diffuse large B cell lymphoma
Non-hodkin, B cells, t(8; 14), children, Africa, “starry sky” histology, rapid growth, facial involvement
Burkitt lymphoma
plasma cell tumor, elderly, “punched out” lesions of calvaria and vertebral bodies, Bence-Jones proteins, M-spike, inverted albumin-globulin ratio (A-G ratio), invasive, incurable
Multiple myeloma
anaplastic myeloid cells, aggressive, replace marrow, suppress hematopoiesis (marrow failure), bleeding, bone pain, pallor, cachexia, poor prognosis
Acute myelogenous leukemia
disordered hematopoieses, pancytopenia, many transform into acute myelogenous leukemia, poor prognosis
Myelodysplastic syndromes (pre-leukemia)
hyperplastic myeloid cells produce too many RBCs, WBCs, and platelets, eventual “spent phase,” may transform into acute myelogenous leukemia
Chronic myeloproliferative disorders
Philadelphia chromosome t(9;22)
Chronic myelogenous leukemia
diffuse marrow fibrosis, extramedullary hematopoiesis, poikilocytes, diagnosed in late stages
Primary myelofibrosis
Birbeck granules (tennis rackets), skin lesions, lymphadenopathy
Langerhans cell histiocytes
massive tissue injury (birthing, sepsis, malignancy, severe trauma), widespread microvascular clotting (stroke, M.I.); may consume all clotting factors (widespread hemorrhage), highly lethal
Disseminated intravascular coagulation
abnormal Willebrand factor (vWF) complex, bleeding gums, underdiagnosed (1% of U.S. population)
von Willebrand disease
mutation of coagulation factor VIII, X-linked recessive
Hemophilia A
mutated coagulation factor IX mutation, X-linked recessive, Christmas disease
Hemophilia B
increase permeability of the glomeruli causing massive proteinuria, hypoalbuminemia in plasma (generalized edema); many causes: diabetes, lupus, Sjögren’s syndrome, sepsis, syphilis, HIV, amyloidosis, vasculitis, cancer, adverse drug reactions
Nephrotic syndrome
most commonly from a bacterial urinary tract infection (upper urinary tract infection) from E. coli, pyrexia, dysuria, flank pain
Pyelonephritis (inflammation of the renal pelvis)
genetic disease that results in massive cysts to develop within the kidneys, children = autosomal recessive, adults = autosomal dominant, common, cause of 10% of chronic renal failure
Polycystic kidney disease
most common cancer of the kidney among adults
Renal cell carcinoma
common childhood cancer, 2-5 years old
Wilms tumor
general term for inflammation of the liver, which damages hepatocytes
Hepatitis
types A-E, common cause of liver cirrhosis
Viral
fecal-oral; 40% of hepatitis cases in U.S., never causes chronic liver disease, “A” involves contact with the arse
Hep. A virus (HAV):
sexual contact, parenteral, breast feeding, birth; 45% of cases in U.S., causes 10% of chronic liver disease, “B” is from blood, birth, and “bonking” (sexual intercourse)
Hep. B virus (HBV)
sexual contact, parenteral; 20% of cases in U.S., causes 80% of chronic liver disease, “C” is very chronic
Hep. C virus (HCV)
sexual contact, parenteral; 1% of cases in U.S., causes 5% of chronic liver disease
Hep. D virus (HDV)
fecal-oral; very rare, more common in pregnant females, never causes chronic liver disease, “vowels” (A, E) never cause chronic liver disease)
Hep. E virus (HEV)
females, no serologic evidence of viral infection, high levels of autoantibodies (IgG), associated with RA, Sjögren’s syndrome, and ulcerative colitis
autoimmune hepatitis
death of hepatocytes with diffuse hepatic nodular fibrosis (loss of liver function), result of viral hepatitis, fatty liver disease (below), autoimmune disease, or iron overload (Wilson disease, below); commonly causes portal hypertension, increased risk of hepatocellular carcinoma (cancer), and may cause lethal hepatic encephalopathy
cirrhosis
: increased blood pressure within the portal venous system, result of cirrhosis, produces abdominal swelling (ascites), splenomegaly, or hepatic encephalopathy (below)
portal hypertension
causes hepatocellular steatosis (fat accumulation)
Fatty liver disease (FLD)
steatosis, alcoholic hepatitis, cirrhosis, develops after 10-15 years of chronic alcoholism
Alcoholic FLD
steatohepatitis, cirrhosis; associated with metabolic syndrome, obesity, type 2 diabetes mellitus, hypertension, and dyslipidemia, becoming more common among pediatrics in the U.S. due to obesity epidemic
Non-alcoholic FLD
excessive deposition of iron in the liver, pancreas, and heart; adult onset, may also develop among individuals with multiple blood transfusions (thalassemia), males are most commonly effected (women have menstruation to lose iron)
Hemochromatosis (iron-overload)
accumulation of toxic levels of copper, autosomal recessive, damages the liver, brain, and eyes, childhood onset, psychosis, tremors, Kayser-Fleischer rings encircle the iris
Wilson disease
liver failure results in shunting of toxins from the liver and into systemic circulation, damages the brain, cerebral edema, causes tremor (asterixis), Babinski sign, confusion, stupor, seizures, coma, or death
Hepatic encephalopathy
common in U.S. (20% of adults), may be cholesterol or pigment (bilirubin)stones, most are asymptomatic, may lead to acute cholecystitis, sever epigastric/right upper quadrant pain when symptomatic, no relationship with any particular diet
Cholelithiasis (gallstones)
commonly due to obstruction of the cystic duct with gallstones (cholelithiasis), pyrexia, pain in the right upper quadrant or epigastric region, commonly refers pain to the right scapula (Boas’ sign)
Cholecystitis (inflammation of the gallbladder)
