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DMD 5243 > Blood Pathology- Bikman > Flashcards

Blood Pathology- Bikman Flashcards

1
Q

Complete Blood Count includes which two major properties?

A

MCV- mean corpuscular volume (size)

MCHC- mean corpuscular hemoglobin concentration (color)

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2
Q

What is anemia and its symptoms?

A

A reduction below normal hemoglobin or normal RBC count.

Symptoms: fatigue, dizziness, jaundice, tachychardia, paleness, breathlessness

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3
Q

What are three major reasons for anemia?

A

Loss of blood
High RBC destruction
Low RBC production

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4
Q

How is bilirubin eliminated from the body?

A

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

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5
Q

What is jaundice and what is the treament?

A

Excessive bilirubin in the body

Treatment: blood transfusion or sun

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6
Q

What does light poo and dark pee mean in terms of jaundice?

A

Extrahepatic Obstructive Jaundice

The bile duct is blocked

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7
Q

What does normal/light poo and light pee mean in terms of jaundice?

A

Intrahepatic Obstructive Jaundice

The liver isn’t working

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8
Q

What does dark poo and dark pee mean in terms of jaundice?

A

Hemolytic anemia

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9
Q

What are key characteristics of microangiopathic hemolytic anemia?

A 
Extracorpuscular
creates schistocytes (frag. of RBCs) due to trauma or injury from sepsis or artificial heart valve
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10
Q

What are key characteristics of autoimmune hemolytic anemia?

A

Extracorpuscular
RBCs attacked by own immune system based on temperature
Warm: IgG
Cold: IgM

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11
Q

What are key characteristics of Sickle Cell anemia?

A

Intracorpuscular
There is a substitution in the beta chain in the hemoglobin (Val for a Glut Acid)
Homozygous genetics are more affected
Clogs vessels

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12
Q

What are key characteristics of Thalassemia?

A

Intracorpuscular
Hypochromic, Microcytic cells
Expansions in the bones to keep up with RBC production
Two types: alpha and beta

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13
Q

What are key characteristics of Hereditary Spherocytosis?

A

Intracorpuscular
Spherocytes
Caused by spectrin defect
Removal of spleen good, because cells trapped in spleen (enlarged spleen)

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14
Q

What are Howell-Jolly Bodies?

A

Any RBC that didn’t completely get rid of its nucleus.

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15
Q

What are key characteristics of G6PDH deficiency?

A

Intracorpuscular
ROS kills RBCs
Heinz bodies: “bite cells” denatured globulins sticks to RBC membrane

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16
Q

What are key characteristics of Fe deficiency?

A 
microcytic, hypochromic
atrophic glossitis (smooth tongue), and koilonychia
Can be from increased Fe loss, decreased Fe intake, increased Fe recruitment
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17
Q

What are key characteristics of anemia of chronic disease?

A

normochromic, normocytic

increased hepcidin in liver from disrupted iron metabolism

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18
Q

What are key characteristics of megaloblastic anemia (pernicious anemia)?

A

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

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19
Q

What is the Schillings Test?

A

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

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20
Q

What are the key characteristics of aplastic anemia?

A

normochromic, normocytic
hypoplastic (empty) bone marrow
more bleeding and compromised immune system
causes: idiopathic, preggers, viruses, drugs

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21
Q

What are the key characteristics of myelophthisic anemia?

A

normochromic, noromocytic
infiltration of tumors in the bone marrow
tear-drop RBCs

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22
Q

What are the key characteristics of neutrophilia?

A

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

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23
Q

What are the key characteristics of lymphocytosis?

A

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

24
Q

What is the key characteristic of basophilia?

A

uncommon

25
Q

What is the key characteristic of monocytosis?

A

Causes: infection, autoimmune disease, malignancies

26
Q

What is the key characteristic of eosinophilia?

A

Causes: drugs, asthma, skin, parasites

27
Q

What is leukemia?

A

Malignancy of hematopoetic cells
Starts in the bone marrow and spreads to blood or nodes
Myeloid or Lymphoid cells

28
Q

What is the difference between acute and chronic?

A

Acute is sudden onset, rapid fatality, children or elderly, immature cells

Chronic is slower onset, longer course in adults, and more mature cells

29
Q

What are key characteristics of acute myeloid leukemia?

A 
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
30
Q

What are the key characteristics of acute lymphoid leukemia?

A

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

31
Q

What are the key characteristics of chronic myeloid leukemia?

A

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

32
Q

What are key characteristics of chronic myelofibrosis?

A

teardrop cells
panmyelosis
advances to marrowfibrosis
extramedullary hematopoesis

33
Q

What are key characteristics of polycythemia vera?

A

thick blood that leads to hypertension

secondary PV- anything that raises EPO

34
Q

What are key characteristics of essential thrombocythemia?

A

high platelet count

secondary thrombocythemia- bleeding or tumors

35
Q

What are key characteristics of chronic lymphoid leukemia?

A 
most common
in adults
indolent (non painful)
incurable
cannot produce antibodies
treatment: treat infections
36
Q

What are the key characteristics of Non-Hodgkin lymphoma?

A

too much lymphocyte
usually in adults 40 or older
symptoms: painless firm lymphodenpathy
B symptoms: weight loss, night sweats, fever

37
Q

What is the difference between low grade and high grade Non-Hodgkins Lymphoma?

A

Low grade - older, incurable, sm. mature cells, non-destructive

High-grade - younger aggressive, large, and destructive

38
Q

What are key characteristics of small lymphocytic lymphoma?

A 
low grade, non-hodgkins 
small mature lymphocytes 
increased CD5
long course 
infections lethal
39
Q

What are the key characteristics of mucosa-associated lymphoid tissue?

A

low grade, non-hodgkins
associated with H. pylori
can be cured with antibiotics

40
Q

What are the key characteristics of follicular lymphoma?

A

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

41
Q

What are the key characteristics of Mycosis Fungoides/Sezary Syndrome?

A

low grade, non-hodgkins
cerebriform lymphocytes
T-cell immunophenotype

42
Q

What are the key characteristics of Large cell Lymphoma?

A

high grade, non-hodgkins

large B cells, bad prognosis, grows rapidly

43
Q

What are the key characteristics of Lymphoblastic Lymphoma?

A

high grade, non-hodgkins
mediastinal mass
teenage boys
same as ALL

44
Q

What are the key characteristics of Burkitt Lymphoma?

A 
high grade, non-hodgkins
associated with EBV
children; usually genetic
extranodal mass
starry sky pattern
45
Q

What are key characteristics of Hodgkins Lymphoma?

A

large lymph nodes, usually occurs in people around 30 years, good prognosis, contiguous spread, reed-sternberg cells (multinucleated cells)

5 subtypes

46
Q

What are the five subtypes of Hodgkins Lymphoma?

A 
Classic:
Nodular sclerosis
Mixed cellularity
Lymphocyte Rich
Lymphocyte Depleted

Non-classic:
lymphocyte predominance

47
Q

What are the key features of Myeloma?

A

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

48
Q

What is CRAB in terms of Myeloma?

A

Calcium elevated
Renal Failure
Anemai
Bone Lytic Lesions

49
Q

Coagulation Tests: what is the difference between partial thromboplastin time and prothrombin?

A

PTT measures intrinsic

PT measures extrinsic

50
Q

What are the key characteristics of Von Willebrand Disease?

A

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

51
Q

What are the key characteristics of Hemophilia A and B?

A

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

52
Q

What are the key characteristics of disseminated intravascular coagulation?

A

Clotting randomly but not where it is needed

can create ischemia in some parts but hemorraging in others

53
Q

What are the key characteristics of thrombotic thrombocytopenia purpura?

A

Thrombotic microangiopathies

deficiency of ADAMST13

54
Q

What are the key characteristics of Hemolytic uremic syndrome?

A

Thrombotic microangiopathies
Related to E.coli and toxin damage endothelium
Symptoms: MAHA, thrombocytopenia, fever

55
Q

What are the key characteristics of idopathic throbocytopenic purpura?

A

Platelets covered in antibodies and therefore cannot do their function.

Get larger bruises

56
Q

What is thrombosis?

A

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)

DMD 5243 (9 decks)

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