Buzzin on WBCs

Question 1

AMML

Answer 1

MPO and nonspecific esterase positive

myelo, monocytic (has granules in it)

Question 2

APL

Answer 2

acute promyelocytic leukemia

DIC, in middle age, Auer rods

t(15;17)

Question 3

Gilbert’s syndrome

Answer 3

• elevation of indirect, unconjugated bilirubin
• the enzyme that conjugates the bilirubin has decreased funcitoning, thus it is not that severe
• brought on by stress
• see total bilirubin of around 2.5 and indirect bili elevated, along with elevated urinary urobilinogen (around just 2-3 is when its seen in the eyes)

Mild inc. unconjugated bili, TB<3, teenaager/adult thats stressed

reduced activity of UDPGT

Question 4

Crigler-Najjar I and II

Answer 4

seen in infants
- degree if hyperbilirubinemia is very high
see lots of unconjugated bilirubin due to absent UDPGT

Question 5

Rotor syndrome

Answer 5

increased conjugated bilirubin, AR inheritence

Question 6

Dubin-Johnson

Answer 6

• increased conjugated bilirubin
• black pigmented liver
• AR inheritence

Question 7

indirect vs. direct bilirubin

Answer 7

indirect = unconjugated
direct = conjugated

Question 8

haptoglobin

Answer 8

soaks up bilirubin, it will be low in a case of hemolytic disease

Question 9

where does hematopoeisis take place at 12 weeks gestation?

Answer 9

in the liver

Question 10

TdT

Answer 10

premature lymphocyte

Question 11

CD56

Answer 11

NK cells

Question 12

sickle cell?

Answer 12

can see infection with parvovirus B19 triggering aplastic anemia (its an infection that looks like redened cheeks, will see fatigue, fainting and fevers)

Question 13

what do you see in chronic illness anemia?

Answer 13

decreased Fe, decreased TIBC, increased ferritin (anemia of chronic inflammation)

Question 14

what are hepcidin level be in a patient of anemia with chronic disease?

Answer 14

its an acute phase reactant, would be increased in state of chronic disease

In states in which the hepcidin level is abnormally high such as inflammation, serum iron falls due to iron trapping within macrophages and liver cells and decreased gut iron absorption. This typically leads to anemia due to an inadequate amount of serum iron being available for developing red cells. When the hepcidin level is abnormally low such as in hemochromatosis, iron overload occurs due to excessive ferroportin mediated iron influx.

Question 15

megaloblastic anemia with hypersegmented neutrophils

Answer 15

seen in B12 deficiency/folate defiency (in other macrocytic anemias you have absence of the hypersegmentation) - these are needed for DNA synthesis

Question 16

Howell-Jolly bodies

Answer 16

think splenectomy

Question 17

Leukemoid reaction

Answer 17

an increase in white blood cell count similar to what occurs in people with leukemia. However, the reaction is actually due to an infection or another disease and is not a sign of cancer. Blood counts will usually return to normal when the underlying condition is treated.

Will have HIGH LAP!!!!
- this is different from CML b/c CML will have normal/low LAP

Question 18

urea breath test

Answer 18

indicative of H. pylori

- this is indicative of Marginal Cell: which is associated with chronic immune stimulation and memory B cells

Question 19

IgM monoclonal spike?

Answer 19

think hyperviscosity

Question 20

overexpression of cyclin D1?

Answer 20

mantle cell lymphoma

Question 21

what are three indolent lymphoplasms?

Answer 21

mantle, marginal, follicular

Question 22

CD11c, CD25, CD103

Answer 22

hairy cell leukemia

Question 23

patient has atypical mycobacterium infection?

Answer 23

think hairy cell leukemia

Question 24

PAX5+

Answer 24

all HL besides lymphocyte predominant

Question 25

where do you see auer rods?

Answer 25

AML

Question 26

APL tx?

Answer 26

called all trans retinoic acid - binds to a mutated receptor inducing maturation of the promyelocytes to myelocytes

Question 27

AML with myelomonocytic maturation (AMML)

Answer 27

myeloperoxidase positive (have monocytes and myelocytes)
monoblasts are positive
inv 16

Question 28

AML with monocytic maturation

Answer 28

myeloperoxidase negative
nonspecific esterase positive (monocytes)
- see tissue infiltration

Question 29

normoblasts

Answer 29

RBC with nucleus = really stressed out bone marrow