CBC 2 Flashcards
1
Q
what is main DDx in ertethrocytosis
A
- increased mass
2. relative - decreased plasma
2
Q
what to measure to assess red cell mass
A
EPO
low - RBC prod. indep of EPO
high - EPO driven
3
Q
2 causes of high RBC and low EPO
A
- polycythemia vera - bone marrow myeloproliferative disorder
- mutation of EPO-r gene
4
Q
2 general causes of high EPO with high RBC
A
- hypoxia
- high altitude
- abnormal Hb - increased EPO production
- CA
- renal cysts
- doping
5
Q
Sx of high RBC
A
HA
- redness
- SOB
- numbness and tingling
6
Q
3 treatments of polycythemia vera
A
- phlebotomy or chemo
- ASA to prevent thrombosis
- JAK2 inhib
7
Q
treatment of EPO mutation
A
phlebotomy
8
Q
what is first question in leukopenia
A
isit real?
- cultral variations
- which leukocytes
9
Q
3 cause of neutopenia and critical levels
A
- low prod
- incr. dest
- sequest
below .5 is major risk of infection
10
Q
4 causes of low production
A
- DRUGS
- bone marrow dis
- benign cyclic neutopenia
- congenital
11
Q
2 causes of destruction
A
autoimmune
alloimune
12
Q
cause of sqesuestration
A
Felty’s seen in RA
13
Q
what is febrile neutopenia
A
- ANC 38.3 - immed. ABs
14
Q
3 types of neutophilia
A
- demarginalziation - push into blood - exercise, stress, indfection
- reactive
- left shift and out of marrow - malignancy in marrow
15
Q
4 causes of lymphopenia
A
- infections
- Chemo/drugs
- congenital
- mild is common on CBC
16
Q
2 types of lymphocytosis
A
- reactive
- viral
- stress
- smoking - lymphoid malig
17
Q
what is first questionn in lymphocytsis
A
- polyclonal or monoclonal
18
Q
3 causes of eosinophilia
A
- alleric
- paracytic infection
- malig.
19
Q
3 causes if monocytosi
A
- chronic infections
- chronic inflammation
- malig
20
Q
2 questions in thrombocytopenia
A
- is it true?
- bleed Hx
- blood film - other line affected?
21
Q
2 causes of pseudothrombocytpenia
A
- clumping
2. satellitism
22
Q
3 features of throbopenia
A
- disorder of PRIMARY hemostatis
2. no Sx until
23
Q
what to ask for on Hx and Phx
A
- bleeding Hx
- recent infection (HIV, hep)
- systemic Sx
- other autoimmune
- past med, surg, transfusion
- fam Hx
- alc
exam - petechiae
- nodes
24
Q
cutoff for levels and treatments of platelets
A
50 - don’t need to treat
25
4 causes of low platetle prod.
1. primary marrow disorder
2. marrow toxin - alc and drugs
3. infection
4. B12 or folate def.
26
2 main classes of platelet dest.
1. immune
- infections, drugs, ITP, HIT, HIV
2. non-immune
- DIC, TTP
27
2 immune types
1. primary ITP
- diagnosis of exclusion
2. secondary
- viral
- SLE
- drug - heparin
- post transfusion
28
4 investigations for ITP
1. repeat CBC
2. review film to look at platelets
3. HIV and hep testing
4. thyroid, liver, renal testing
29
what is ITP
- immune mediated early destruction
- inappropriate TPO response
- plats. less than 20 typically
30
treatment of ITP
immed - steroids, IVIG
| longterm - splenectomy, immune supression
31
5 non-immune cause of plate dest.
1. drugs
2. DIC/sepsis
3. mechanical
4. TTP clotting activation
5. pre-eclampsia
32
what is TTP
thrombotic thromobocytopenia pupura
- high platelet consumption
- high mortality
- clots in small vessels and uncontrolled VWF
- bleed and clot
33
3 causes of thrombocytosis
1. reactive
- infection/inflammation
- marrow inflammation
2. malignancy
3. redistributive
34
main microcytic
1. Fe #1
2. Thal
3. sideroblastic
35
2 main causes of Fe def,
1. blood loss
- menstrual then GI
2. diet def.
36
5 lab tests for Fe
1. ferritin
2. TIBC up
3. high transferritin
4. lowe serum iron
5. microcytic hypochromic cells on smear
37
3 way to Tx Fe def.
1. oral Fe replacement
2. paraenteral replacement
3. transfusion
38
main issue in thal
inheritied inadequate production of a or B chain of Hb
39
2 main types of thal
a - can be sever to carrier depending on number of gene loci
| B - most often in mediteranian
40
Sx of B thal
- severe anemia
- massive hepatospleno
- expansion of marrow space- distorted bones
- growth retard
41
Dx of thal B
1. electrophoresis - high HbF
| 2. smear - microcytic hypochromic anemia
42
4 classes of a thal
1. silent carrier - one loci
2. trait - two loci
- mild and no Tx
3. HbH - 3 loci
- sig anmeia
4. all 4 - death
43
what is sideroblastic
abnormality in RBC production
- hereditary or acquired
-
44
2 main normocytics
1. anemia of chronic disease
- may also be microcytic
2. aplastic
45
what is mech in anemia of chonic disease
chronic infection leads to cytokine release which have suppressive effects on production
46
what is aplastic
bone marrow makes none - pancytopenia
47
5 main causes of aplastic
1. idiopathic
2. rads
3. meds
4. viral
5. chemical
48
3 Tx of aplastic
1. bone marrow transplant
2. transfusion
3. immunsupression
49
2 main macro causes
1. B12 def
| 2. folate def.
