Buzzwords - Hematology Flashcards
hemolytic anemia w/
Hgb S on hemoglobin electrophoresis
Sickle cell anemia
+ sickled cells on peripheral smear
hemolytic anemia w/
microcytic anemia w/ normal/inc serum Fe or no response to Fe treatment
Thalassemia - assoc w/ severe anemia & abnormal smear for given hematocrit level
ALPHA: hgb electrophoresis w/ NORMAL HGB RATIOS of HgbA, A2, F (diagnosis of exclusion since smear normal)
BETA: hgb electrophoresis DEC HgbA, INC HgbF
hemolytic anemia w/
EPISODIC hemolytic anemia associated w/ SULFA DRUGS, FAVA BEANS, INFECTIONS
G6PD DEFICIENCY
hemolytic anemia w/
microspherocytes, COOMBS NEGATIVE
hereditary spherocytosis
hemolytic anemia w/
microspherocytes, COOMBS POSITIVE
autoimmune hemolytic anemia
hemolytic anemia w/
normal coags
thrombocytopenia, hemolytic anemia, kidney damage, NEURO SX, FEVER
TTP
hemolytic anemia w/
normal coags
thrombocytopenia, hemolytic anemia & KIDNEY DAMAGE
hemolytic uremic syndrome (HUS)
- mc seen in children (esp w/ diarrhea prodrome)
- higher assoc w/ kidney damage than TTP, doesn’t classically have fever or neuro sx
hemolytic anemia w/ abnormal coags (prolonged PT + PTT)
disseminated intravascular coagulation (DIC)
hemolytic anemia w/ dark urine (worse in mornings)
paryoxysmal nocturnal hemoglobinuria
peripheral smear: rouleaux formation
- RBC stick as “STACK OF COINS” due to inc plasma proteins (like immunoglobulins or fibrinogen)
- inc density of them stuck causes them to settle in tube faster –> INC ESR
MULTIPLE MYELOMA (high protein) INFECTIONS (acute/chronic - have high fibrinogen)
peripheral smear: auto agglutination
- CLUMPING OF RBC due to IgM auto-antibodies coating surface of RBC lead to inc RBC destruction by macrophages
- cold IgM Ab agglutinins are reactive at colder temps (28-31 C)
COLD AGGLUTININ AUTOIMMUNE HEMOLYTIC ANEMIA (mycoplasma pneumonia, EBV)
Cryoglobulinemia
Ag-Ab reaction if blood type not matched
peripheral smear: HOWELL-JOLLY BODIES
-small dense basophilic RBC inclusions (usually removed by spleen)
DECREASED SPLENIC FX: autosplenectomy (ex. sickle cell), post splenectomy
SEVERE HEMOLYTIC ANEMIA, MEGALOBLASTIC ANEMIA
peripheral smear: hemolytic cells - BITE CELLS
-bite-like deformity due to phagocyte removal of denatured Hgb
THALASSEMIA
G6PD DEFICIENCY
peripheral smear: hemolytic cells - SHISTOCYTES
-fragmented RBC
HEMOLYTIC ANEMIAS
MICROANGIOPATHIC DZ
peripheral smear: hemolytic cells - KERATOCYTES
-“helmet-shaped” RBCs –> mechanical RBC damage in small vessels
microangiopathic dz like TTP, HUS, DIC, PROSTHETIC VALVES
peripheral smear: BASOPHILIC STIPPLING
-course blue granules in RBC (residual RNA) - looks like reticulocytes but STIPPLING EVENLY DISTRIBUTED
SIDEROBLASTIC ANEMIA
HEAVY METAL POISONING (LEAD)
THALASSEMIAS
myelodysplasia, chronic alcohol abuse
peripheral smear: ECHINOCYTES “BURR CELLS”
-RBCs w/ numerous, small, evenly spaced projections due to abnormal cell membrane
UREMIA
pyruvate kinase deficiency
hypophosphatemia
peripheral smear: ACANTHOCYTES “SPUR CELLS”
-Few, large, spiny, irregular projections on the RBC membrane
Liver Dz Post Splenectomy Thalassemia Autoimmune Hemolytic Anemia Renal Dz
peripheral smear: TARGET CELLS (Codocytes) & SPHEROCYTES
TARGET CELL: hypochromic RBC w/ round area of central pigment “target-shaped”
- seen if there is excess of cell membrane relative to hgb
- HEMOGLOBINOPATHIES: SICKLE CELL, THALASSEMIA, sev Fe deficiency, asplenia, liver dz
SPHEROCYTES: usually associated w/ hyperchromia (often w/ microcytosis)
- HEREDITARY SPHEROCYTOSIS
- WARM AUTOIMMUNE HEMOLYTIC ANEMIA
peripheral smear: HYPERSEGMENTED NEUTROPHILS
-neutrophils w/ >5 lobes
B12 & FOLATE DEFICIENCIES
peripheral smear: AUER RODS
ACUTE MYELOGENOUS LEUKEMIA (AML)
peripheral smear: REED-STERNBERG CELL “OWL EYE APPEARANCE”
HODGKIN LYMPHOMA
plummer-vinson syndrome
dysphagia, esophageal webs, atrophic glossitis, Fe deficiency
thrombocytopenia
low platelet count
prolonged PT
VIT K DEFICIENCY ( WARFARIN)
DIC
prolonged PTT
HEMOPHILIAS
VON WILLEBRAND DISEASE
DIC
prolonged bleeding time
THROMBOCYTOPENIA
VON WILLEBRAND DZ, ESP W/ ASA
DIC
BM biopsy: DUTCHER BODIES
waldenstrom macroglobulinemia
thrombocytopenia sx
MUCOCUTANEOUS BLEEDING PETECHIAE small, superficial bruising BLEED AFTER MINOR CUTS IMMEDIATE BLEEDING AFTER SURGERY
factor deficiency sx (ex hemophilias)
DEEP BLEEDING (joint, muscles) petechiae uncommon LARGE HEMATOMAS (not small bruises) unusual bleeding after small cuts DELAYED BLEED AFTER SURGERY
SMUDGE CELLS
CLL
MC LEUKEMIA IN ADULTS
METALLIC OR BRONZE SKIN –> “BRONZE DIABETES”
hereditary hemochromatosis
-increased Fe absorption and deposition into organs
