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DMD 5243 > Blood Pathology Pt 1: Anemia and Leukemia > Flashcards

Blood Pathology Pt 1: Anemia and Leukemia Flashcards

1
Q

2 major parts of a complete blood count

A

mcv - mean corpuscular volume

mchc - mean corpuscular Hb concentration

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2
Q

“-cytic”

A

refers to cell size (mcv)

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3
Q

“-chromic”

A

refers to cell color/amount of Hb (mchc)

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4
Q

anisocytosis

A

size variation

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5
Q

poikilocytosis

A

shape variation

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6
Q

anemia

A

reduction below normal in Hb or rbc number

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7
Q

causes of anemia

A

blood loss
excessive rbc destruction
insufficient rbc production

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8
Q

signs of destruction in hemolytic anemia

A

increased bilirubin, increased LDH, reduced haptoglobin

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9
Q

signs of production in hemolytic anemia

A

increased reticulocytes, nucleated red cells in blood

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10
Q

glucuronyl transferase

A

makes unconjugated bilirubin+albumin soluble by adding a sugar
is then excreted to the small intestine then feces

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11
Q

urobilinogen

A

made in the gut from bilirubin
can be excreted in feces or reabsorbed in blood
liver can metabolize it into bile

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12
Q

causes of jaundice

A

excess bilirubin production

decreased bilirubin excretion

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13
Q

t/f. bilirubin is toxic to brain cells

A

true

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14
Q

treatment of jaundice

A

treat cause, blood transfusion, sun

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15
Q

extrahepatic obstructive jaundice

A

light/clay colored feces, dark urine

obstruction of bile duct

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16
Q

intrahepatic obstructive jaundice

A

normal/light colored feces, light urine

damaged hepatocytes

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17
Q

hemolytic anemia

A

dark feces and urine

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18
Q

microangiopathic hemolytic anemia

A

extracorpuscular hemolytic anemia
shistocytes (rbc fragment)
causes - artificial heart valve, malignancy, obstetric complications, sepsis, trauma

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19
Q

autoimmune hemolytic anemia

A

extracorpuscular hemolytic anemia
warm (igG, spleen, spheocytes)
cold (igM complement, intravascular hemolysis, agglutination)

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20
Q

sickle cell anemia

A 
intracorpuscular hemolytic anemia
sickles clog vessels and are fragile
aa substitution in beta chain
african ethnicity
infarcted spleen with HbS
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21
Q

thalassemia

A 
intracorpuscular hemolytic anemia
increased rbc synthesis
alpha chain (SE asian)
beta chain (mediterranean)
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22
Q

hereditary spheocytosis

A

intracorpuscular hemolytic anemia
SPHEROCYTES
treatment - spenectomy

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23
Q

howell-jolly bodies

A

evidence of markedly decreased splenic function

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24
Q

g6pdh deficiency

A

intracorpuscular hemolytic anemia
ros exposure will kill rbcs
removal of heinz bodies (bite cells)

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25
Q

heinz bodies

A

globin denatures, sticks to rbc membrane

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26
Q

iron deficiency

A 
microcytic, hypochromic anemia
atrophic glossitis/koilonychia
causes:
decreased iron intake
increased iron loss
increased iron requirement
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27
Q

anemia of chronic disease

A

normochromic, normocytic anemia
causes:
disrupted iron metabolism

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28
Q

megaloblastic anemia

A

normochromic, macrocytic anemia
causes:
reduced b12/folate in the body (insufficient intrinsic factor)
PERNICIOUS ANEMIA

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29
Q

what do blood contents look like in megaloblastic anemia?

A

large, oval shaped rbcs

hypersegmented neutrophils

30
Q

schilling test

A

tests b12 absorption for pernicious anemia
stage 1 - feed labeled b12, inject b12
if abnormal (less than 10% in urine proceed to stage 2)
stage 2 - feed labled b12+IF
if b12 normal, patient has PA
if b12 reduced, patient has gi pathology

31
Q

aplastic anemia

A

normochromic, normocytic anemia
hypoplatic (empty) bone marrow
pncytopenia - compromised immune function
causes:
idiopathic, drugs, viruses, pregnancy, fanconi anemia

32
Q

myelophthisic anemia

A

normochromic, normocytic anemia
causes:
infiltration of bone marrow by tumors or fibrosis
tear drop shaped rbcs

33
Q

leukocytosis

A

wbc count above normal range

34
Q

neutrophilia

A

benign leukocytosis

mature and immature

35
Q

mature neutrophilia

A

highly segmented
causes: bacterial infection, inflammation, stress
toxic changes: granulation, dohle bodies, vacuolization

36
Q

immature neutrophilia

A

not segmented
causes: infection, inflammation, severe anemia, marrow displacement
3 forms

37
Q

3 forms of immature neutrophilia

A

left shift (more immature than mature wbcs)
leukemoid reaction - elevation in leukocytes in response to stress or infection
leukoerythroblastic reaction - same as leukemoid but with nucleated rbc

38
Q

lymphocytosis

A

benign leukocytosis

mature and reactive

39
Q

mature lymphocytosis

A

lots of normal cells

causes: infectious lymphocytosis, bordatella pertussis, transient stress

40
Q

reactive lymphocytosis

A

lots of abnormal cells

causes: mono, pediatric viral infections, viral hepatitis, immune disorders (downey cells)

41
Q

basophilia

A

benign leukocytosis
uncommon
component of chronic myelogenous leukemia

42
Q

monocytosis

A

benign leukocytosis

causes: infection, autoimmune disease, malignancy

43
Q

eosinophilia

A

benign leukocytosis

causes: drugs, asthma, skin diseases, parasites

44
Q

differences between leukemia and lymphoma

A

leukemia - starts in bone marrow, can spread to blood nodes, myeloid or lymphoid, acute or chronic
lymphoma - starts in lymph nodes, can spead to blood, marrow, lymphoid only, hodgkin or non hodgkin

45
Q

acute

A

sudden onset
occurs in children and adults over 60
rapidly fatal w/o treatment
immature cells (blasts)

46
Q

chronic

A

slow onset
only in adults
longer course
mature cells

47
Q

acute leukemia

A

malignant proliferation of immature myeloid or lymphoid cells in bone marrow

48
Q

acute leukemia causes

A

clonal expansion

maturation failure

49
Q

acute leukemia symptoms

A 
fatigue
infections
bleeding
bone pain
lymphadenopathy
50
Q

lethality of acute leukemia

A

inhibition of normal cell function

infiltration of organs

51
Q

acute myeloid leukemia

A

malignant proliferation of myeloid blasts in blood and bone marrow
many subtypes
bad prognosis
in adults

52
Q

auer rods

A

AML-M3

clumps of granular material that form elongated needles in the cyto of the leukemic blasts

53
Q

which subtype of acute myeloid leukemia results in a shortage of blood platelets?

A

aml-m5

54
Q

which subtype of acute myeloid leukemia results in multinucleated erythroblasts?

A

aml-m6

55
Q

treatment of aml

A

chemotherapy

bone marrow transplant

56
Q

acute lymphoblastic leukemia

A

malignant proliferation of lymphoid blasts in blood and bone marrow
common in children
good prognosis
classified by B vs T

57
Q

t lineage all

A

bad prognosis

58
Q

b lineage all

A

b cell precursor all = better prognosis

b cell all = bad prognosis

59
Q

treatment of all

A

chemotherapy

bone marrow transplant

60
Q

chronic leukemia

A

malignant proliferation of mature myeloid or lymphoid cells in the bone marrow

61
Q

causes of chronic leukmia

A

clonal expansion

functional failure

62
Q

symptoms of chronic leukemia

A 
weight loss
fatigue
infections
bone pain
similar to acute but MORE GRADUAL
63
Q

lethality of chronic leukemia

A

inhibition of normal cell funtion

infiltration of organs

64
Q

chronic myeloid leukemia

A

neutrohpilic leukocytes
basophilia
PHILADELPHIA CHROMOSOME
three phases (chronic, accelerated, blast)

65
Q

treatment of cml

A

imatinib, used to be bone marrow transplant

66
Q

prognosis of cml

A

can be longer than 5 years

67
Q

chronic myelofibrosis

A

panmyelosis (form of myeloid metaplasia
advancing to marrow fibrosis
extramedullary hematopoiesis
teardrop rbcs

68
Q

polycythemia vera

A

high hemocrit

can cause hypertension

69
Q

essential thrombocythemia

A

high platelet count

70
Q

chronic lymphocytic leukemia

A 
malignant proliferation of lymphocytes in the blood and bone marrow
MOST COMMON LEUKEMIA
only in adults
long course
little/no pain mostly incurable
cd5+ b cells (cannot produce antibodies)
71
Q

treatment of cll

A

treat infections

72
Q

prognosis of cll

A

monitor wbc counts

9 years

DMD 5243 (11 decks)

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