Blood Pathology- Bikman Flashcards
Complete Blood Count includes which two major properties?
MCV- mean corpuscular volume (size)
MCHC- mean corpuscular hemoglobin concentration (color)
What is anemia and its symptoms?
A reduction below normal hemoglobin or normal RBC count.
Symptoms: fatigue, dizziness, jaundice, tachychardia, paleness, breathlessness
What are three major reasons for anemia?
Loss of blood
High RBC destruction
Low RBC production
How is bilirubin eliminated from the body?
Bilirubin-albumin complex transfers to the liver from the spleen
Glucuronyl Transferase binds and transfers to small intestines along with bile
Some bilirubin can be converted to urobilinogen by intestinal bacteria, which can be reabsorbed or excreted along with the bile or urine
What is jaundice and what is the treament?
Excessive bilirubin in the body
Treatment: blood transfusion or sun
What does light poo and dark pee mean in terms of jaundice?
Extrahepatic Obstructive Jaundice
The bile duct is blocked
What does normal/light poo and light pee mean in terms of jaundice?
Intrahepatic Obstructive Jaundice
The liver isn’t working
What does dark poo and dark pee mean in terms of jaundice?
Hemolytic anemia
What are key characteristics of microangiopathic hemolytic anemia?
Extracorpuscular creates schistocytes (frag. of RBCs) due to trauma or injury from sepsis or artificial heart valve
What are key characteristics of autoimmune hemolytic anemia?
Extracorpuscular
RBCs attacked by own immune system based on temperature
Warm: IgG
Cold: IgM
What are key characteristics of Sickle Cell anemia?
Intracorpuscular
There is a substitution in the beta chain in the hemoglobin (Val for a Glut Acid)
Homozygous genetics are more affected
Clogs vessels
What are key characteristics of Thalassemia?
Intracorpuscular
Hypochromic, Microcytic cells
Expansions in the bones to keep up with RBC production
Two types: alpha and beta
What are key characteristics of Hereditary Spherocytosis?
Intracorpuscular
Spherocytes
Caused by spectrin defect
Removal of spleen good, because cells trapped in spleen (enlarged spleen)
What are Howell-Jolly Bodies?
Any RBC that didn’t completely get rid of its nucleus.
What are key characteristics of G6PDH deficiency?
Intracorpuscular
ROS kills RBCs
Heinz bodies: “bite cells” denatured globulins sticks to RBC membrane
What are key characteristics of Fe deficiency?
microcytic, hypochromic atrophic glossitis (smooth tongue), and koilonychia Can be from increased Fe loss, decreased Fe intake, increased Fe recruitment
What are key characteristics of anemia of chronic disease?
normochromic, normocytic
increased hepcidin in liver from disrupted iron metabolism
What are key characteristics of megaloblastic anemia (pernicious anemia)?
normochromic, macrocytic
low B12/folate in the body, cells cannot split
usually from not enough intrinsic factor, which doesnt allow absorption
can also lead to hypersegmented neutrophils
What is the Schillings Test?
It is a test to determine if a person has pernicious anemia
Stage 1
Given oral B12 and injected B12 an hour later
If urine has over 10% of B12 then normal
If urine has under 10% B12 then abnormal and proceed to stage 2
Stage 2
Given oral B12 and intrinsic factor
If B12 is normal then has PA
If B12 is still decreased then patient has GI pathology
What are the key characteristics of aplastic anemia?
normochromic, normocytic
hypoplastic (empty) bone marrow
more bleeding and compromised immune system
causes: idiopathic, preggers, viruses, drugs
What are the key characteristics of myelophthisic anemia?
normochromic, noromocytic
infiltration of tumors in the bone marrow
tear-drop RBCs
What are the key characteristics of neutrophilia?
benign leukocytosis
too many neutrophils
two types: immature and mature
mature has dohle bodies
immature has band cells
mature caused by infection, stress, and inflammation
immature caused by severe anemia, marrow displacement, infection, and inflammation
inflammation has three types of cells: left shift, leukemoid reaction and leukoerythroblastoic
What are the key characteristics of lymphocytosis?
benign leukocytosis
caused from fighting an infection
two types
mature: lots of normal cells from infectious, pertussis, transient stress
reactive: lots of abnormal cells from viral hepititis, immune disorders, mononucleosis, pediatric viral infections
has downey cells: abnormal nucleus
What is the key characteristic of basophilia?
uncommon
What is the key characteristic of monocytosis?
Causes: infection, autoimmune disease, malignancies
What is the key characteristic of eosinophilia?
Causes: drugs, asthma, skin, parasites
What is leukemia?
Malignancy of hematopoetic cells
Starts in the bone marrow and spreads to blood or nodes
Myeloid or Lymphoid cells
What is the difference between acute and chronic?
Acute is sudden onset, rapid fatality, children or elderly, immature cells
Chronic is slower onset, longer course in adults, and more mature cells
What are key characteristics of acute myeloid leukemia?
malignant proliferation of immature myeloid blasts bad prognosis many types Auer rods in M3 Shortage of platelets in M5 Multinucleated RBC in M6 treatment: chemo or bone marrow transplant myelodysplastic syndrome can lead to AML
What are the key characteristics of acute lymphoid leukemia?
most common in children
good prognosis
“hazy” nucleus
classified by immunophenotype (T is bad; B has starry sky pattern)
treatment: chemo or bone marrow transplant
What are the key characteristics of chronic myeloid leukemia?
longer course
hypercellular bone marrow
left shift
usually in adults
philidelphia chromosome (translocation of 9 + 22)
three phases going from ok to bad (chronic, accelerated, blast)
treament: gleevec
What are key characteristics of chronic myelofibrosis?
teardrop cells
panmyelosis
advances to marrowfibrosis
extramedullary hematopoesis
What are key characteristics of polycythemia vera?
thick blood that leads to hypertension
secondary PV- anything that raises EPO
What are key characteristics of essential thrombocythemia?
high platelet count
secondary thrombocythemia- bleeding or tumors
What are key characteristics of chronic lymphoid leukemia?
most common in adults indolent (non painful) incurable cannot produce antibodies treatment: treat infections
What are the key characteristics of Non-Hodgkin lymphoma?
too much lymphocyte
usually in adults 40 or older
symptoms: painless firm lymphodenpathy
B symptoms: weight loss, night sweats, fever
What is the difference between low grade and high grade Non-Hodgkins Lymphoma?
Low grade - older, incurable, sm. mature cells, non-destructive
High-grade - younger aggressive, large, and destructive
What are key characteristics of small lymphocytic lymphoma?
low grade, non-hodgkins small mature lymphocytes increased CD5 long course infections lethal
What are the key characteristics of mucosa-associated lymphoid tissue?
low grade, non-hodgkins
associated with H. pylori
can be cured with antibiotics
What are the key characteristics of follicular lymphoma?
low grade, non-hodgkins
small cleaved cells “centroblasts”
grade based on centroblasts count
stages: 1. single node 2. 2 or more nodes on same side of diaphram 3. lymph nodes on both sides of diaphram 4. diffuse extranodal involvement
first two stages have a better chance of 5 year survival
What are the key characteristics of Mycosis Fungoides/Sezary Syndrome?
low grade, non-hodgkins
cerebriform lymphocytes
T-cell immunophenotype
What are the key characteristics of Large cell Lymphoma?
high grade, non-hodgkins
large B cells, bad prognosis, grows rapidly
What are the key characteristics of Lymphoblastic Lymphoma?
high grade, non-hodgkins
mediastinal mass
teenage boys
same as ALL
What are the key characteristics of Burkitt Lymphoma?
high grade, non-hodgkins associated with EBV children; usually genetic extranodal mass starry sky pattern
What are key characteristics of Hodgkins Lymphoma?
large lymph nodes, usually occurs in people around 30 years, good prognosis, contiguous spread, reed-sternberg cells (multinucleated cells)
5 subtypes
What are the five subtypes of Hodgkins Lymphoma?
Classic: Nodular sclerosis Mixed cellularity Lymphocyte Rich Lymphocyte Depleted
Non-classic:
lymphocyte predominance
What are the key features of Myeloma?
Features: monoclonal gammopathy (cannot produce antibodies), osteolytic lesions, increased plasma cells
Manifestation: weakness, infection, bone pain, Bence Jones proteins in urine, renal failure
Treatment: chemo/radiation, bone marrow transplant
What is CRAB in terms of Myeloma?
Calcium elevated
Renal Failure
Anemai
Bone Lytic Lesions
Coagulation Tests: what is the difference between partial thromboplastin time and prothrombin?
PTT measures intrinsic
PT measures extrinsic
What are the key characteristics of Von Willebrand Disease?
Most common bleeding disorder
Autosomal dominant
VW factor is low
Symptoms: mucosal bleeding, deep joint bleeding
Lab tests:
bleeding time long?
PTT long
PT normal
What are the key characteristics of Hemophilia A and B?
A- most common factor deficiency, X linked recessive, factor 8 reduced
B- factor 9 low, less common, x-linked recessive, similar clinical presentation
Both coagulation test normal
What are the key characteristics of disseminated intravascular coagulation?
Clotting randomly but not where it is needed
can create ischemia in some parts but hemorraging in others
What are the key characteristics of thrombotic thrombocytopenia purpura?
Thrombotic microangiopathies
deficiency of ADAMST13
What are the key characteristics of Hemolytic uremic syndrome?
Thrombotic microangiopathies
Related to E.coli and toxin damage endothelium
Symptoms: MAHA, thrombocytopenia, fever
What are the key characteristics of idopathic throbocytopenic purpura?
Platelets covered in antibodies and therefore cannot do their function.
Get larger bruises
What is thrombosis?
intravascular clot or thrombus
fates: propagation, embolization, dissolution, organization, recanalization
two types: mural (adheres to cell wall, partially restricting) and occlusive (thrombi that cuts off blood flow)
