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CBC 2 Flashcards

1
Q

what is main DDx in ertethrocytosis

A
  1. increased mass

2. relative - decreased plasma

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2
Q

what to measure to assess red cell mass

A

EPO
low - RBC prod. indep of EPO
high - EPO driven

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3
Q

2 causes of high RBC and low EPO

A
  1. polycythemia vera - bone marrow myeloproliferative disorder
  2. mutation of EPO-r gene
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4
Q

2 general causes of high EPO with high RBC

A
  1. hypoxia
    - high altitude
    - abnormal Hb
  2. increased EPO production
    - CA
    - renal cysts
    - doping
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5
Q

Sx of high RBC

A

HA

  • redness
  • SOB
  • numbness and tingling
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6
Q

3 treatments of polycythemia vera

A
  1. phlebotomy or chemo
  2. ASA to prevent thrombosis
  3. JAK2 inhib
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7
Q

treatment of EPO mutation

A

phlebotomy

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8
Q

what is first question in leukopenia

A

isit real?

  • cultral variations
  • which leukocytes
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9
Q

3 cause of neutopenia and critical levels

A
  1. low prod
  2. incr. dest
  3. sequest
    below .5 is major risk of infection
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10
Q

4 causes of low production

A
  1. DRUGS
  2. bone marrow dis
  3. benign cyclic neutopenia
  4. congenital
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11
Q

2 causes of destruction

A

autoimmune

alloimune

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12
Q

cause of sqesuestration

A

Felty’s seen in RA

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13
Q

what is febrile neutopenia

A
  1. ANC 38.3 - immed. ABs
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14
Q

3 types of neutophilia

A
  1. demarginalziation - push into blood - exercise, stress, indfection
  2. reactive
    - left shift and out of marrow
  3. malignancy in marrow
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15
Q

4 causes of lymphopenia

A
  1. infections
  2. Chemo/drugs
  3. congenital
  4. mild is common on CBC
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16
Q

2 types of lymphocytosis

A
  1. reactive
    - viral
    - stress
    - smoking
  2. lymphoid malig
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17
Q

what is first questionn in lymphocytsis

A
  1. polyclonal or monoclonal
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18
Q

3 causes of eosinophilia

A
  1. alleric
  2. paracytic infection
  3. malig.
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19
Q

3 causes if monocytosi

A
  1. chronic infections
  2. chronic inflammation
  3. malig
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20
Q

2 questions in thrombocytopenia

A
  1. is it true?
    - bleed Hx
    - blood film
  2. other line affected?
21
Q

2 causes of pseudothrombocytpenia

A
  1. clumping

2. satellitism

22
Q

3 features of throbopenia

A
  1. disorder of PRIMARY hemostatis

2. no Sx until

23
Q

what to ask for on Hx and Phx

A
  1. bleeding Hx
  2. recent infection (HIV, hep)
  3. systemic Sx
  4. other autoimmune
  5. past med, surg, transfusion
  6. fam Hx
  7. alc
    exam
  8. petechiae
  9. nodes
24
Q

cutoff for levels and treatments of platelets

A

50 - don’t need to treat

25
Q

4 causes of low platetle prod.

A
  1. primary marrow disorder
  2. marrow toxin - alc and drugs
  3. infection
  4. B12 or folate def.
26
Q

2 main classes of platelet dest.

A
  1. immune
    - infections, drugs, ITP, HIT, HIV
  2. non-immune
    - DIC, TTP
27
Q

2 immune types

A
  1. primary ITP
    - diagnosis of exclusion
  2. secondary
    - viral
    - SLE
    - drug - heparin
    - post transfusion
28
Q

4 investigations for ITP

A
  1. repeat CBC
  2. review film to look at platelets
  3. HIV and hep testing
  4. thyroid, liver, renal testing
29
Q

what is ITP

A
  • immune mediated early destruction
  • inappropriate TPO response
  • plats. less than 20 typically
30
Q

treatment of ITP

A

immed - steroids, IVIG

longterm - splenectomy, immune supression

31
Q

5 non-immune cause of plate dest.

A
  1. drugs
  2. DIC/sepsis
  3. mechanical
  4. TTP clotting activation
  5. pre-eclampsia
32
Q

what is TTP

A

thrombotic thromobocytopenia pupura

  • high platelet consumption
  • high mortality
  • clots in small vessels and uncontrolled VWF
  • bleed and clot
33
Q

3 causes of thrombocytosis

A
  1. reactive
    - infection/inflammation
    - marrow inflammation
  2. malignancy
  3. redistributive
34
Q

main microcytic

A
  1. Fe #1
  2. Thal
  3. sideroblastic
35
Q

2 main causes of Fe def,

A
  1. blood loss
    - menstrual then GI
  2. diet def.
36
Q

5 lab tests for Fe

A
  1. ferritin
  2. TIBC up
  3. high transferritin
  4. lowe serum iron
  5. microcytic hypochromic cells on smear
37
Q

3 way to Tx Fe def.

A
  1. oral Fe replacement
  2. paraenteral replacement
  3. transfusion
38
Q

main issue in thal

A

inheritied inadequate production of a or B chain of Hb

39
Q

2 main types of thal

A

a - can be sever to carrier depending on number of gene loci

B - most often in mediteranian

40
Q

Sx of B thal

A
  • severe anemia
  • massive hepatospleno
  • expansion of marrow space- distorted bones
  • growth retard
41
Q

Dx of thal B

A
  1. electrophoresis - high HbF

2. smear - microcytic hypochromic anemia

42
Q

4 classes of a thal

A
  1. silent carrier - one loci
  2. trait - two loci
    - mild and no Tx
  3. HbH - 3 loci
    - sig anmeia
  4. all 4 - death
43
Q

what is sideroblastic

A

abnormality in RBC production
- hereditary or acquired
-

44
Q

2 main normocytics

A
  1. anemia of chronic disease
    - may also be microcytic
  2. aplastic
45
Q

what is mech in anemia of chonic disease

A

chronic infection leads to cytokine release which have suppressive effects on production

46
Q

what is aplastic

A

bone marrow makes none - pancytopenia

47
Q

5 main causes of aplastic

A
  1. idiopathic
  2. rads
  3. meds
  4. viral
  5. chemical
48
Q

3 Tx of aplastic

A
  1. bone marrow transplant
  2. transfusion
  3. immunsupression
49
Q

2 main macro causes

A
  1. B12 def

2. folate def.

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