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Boards.CP.Heme > Diagnosis of Quantitative Abnormalites > Flashcards

Diagnosis of Quantitative Abnormalites Flashcards

1
Q

What does anemia with reticulocytosis suggest?

A

Hyperregenerative anemia

-Hemolysis or Hemorrhage

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2
Q

What are the Hemolysis screening tests?

A
  • Lactate Dehydrogenase (Increased)
  • Haptoglobin (Decreased)
  • Bilirubin (Increased)
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3
Q

Causes of Intravascular hemolysis. (6)

A
  • Microangiopathic Hemolytic Anemia
  • Complement fixation on RBC
  • Mechanical Heart Valve
  • Oxidant stress (G6PD deficiency)
  • Snake Venom
  • Infection
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4
Q

What are causes of Microangiopathic Hemolytic Anemia? (4)

A
  • DIC
  • HUS
  • TTP
  • HELLP
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5
Q

What causes complement fixation on the red cell surface? (3)

A
  • ABO incompatibility
  • PNH
  • PCH
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6
Q

What infections cause Intravascular hemolysis?

A
  • Malaria
  • Babesiosis
  • Clostridium
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7
Q

Reactive Neutrophilia:

  • count
  • morphologic findings
A
  • Does NOT exceed 30x10^3
  • Toxic granulations, Dohle bodies, Cytoplasmic vacuoles

*immature cells - bands and metamyelocytes

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8
Q

Chronic Myeloid Leukemia (CML):

  • presentation
  • P.smear (3)
  • Leukocyte Alkaline Phosphatase score
A 
-Unexplained and prolonged neutrophilia
P.Smear:
-Lacks "toxic" morphology
-Basophilia
-"Myelocyte Bulge"

-LAP score is DECREASED

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9
Q

Infectious monocytosis is most commonly caused by what infections? (4)

A
  • EBV
  • CMV
  • HIV (acute)
  • Toxoplasmosis
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10
Q

The peripheral blood “monocytosis” is caused by a proliferation of what cell type?

A

Reactive T-Lymphocytes

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11
Q

The syndrome of persistent polyclonal B lymphocytosis:

  • Population
  • Morphology
  • Hypergammaglobulinemia type
  • Cytopenias (yes/no)
  • HLA type in most people
A
  • Young adult female smokers
  • Indented to bilobed nuclei with abundant pale cytoplasm
  • Polyclonal IgM
  • NO cytopenias
  • HLA-DR7+
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12
Q

Reactive lymphocytosis in children:

  • Classic association
  • Morphology
A
  • Pertussis

- Small, mature lymphs w/ clefted nuclei (Reider cells)

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13
Q

CMML findings:

A
  • Persistent monocytosis w/ immature forms

- Splenomegaly

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14
Q

Syndromes associated with Eosinophilia. (4)

A
  • Cellulitis (Well syndrome)
  • Pneumonia (Loeffler syndrome)
  • Fasciitis (Schulman syndrome)
  • Vasculitis (Churg-Strauss syndrome)
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15
Q

Which cytokine stimulates the eosinophil lineage?

A

IL-5

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16
Q

What is the most common cause of neutropenia (agranulocytosis)?

A

Medications

17
Q

Felty syndrome triad.

A
  • Rheumatoid Arthritis
  • Splenomegaly
  • Neutropenia
18
Q

What infections are associated with Neutropenia? (4)

A
  • Typhoid fever
  • Brucellosis
  • Tularemia
  • Rickettsia

*In neonates and elderly, overwhelming sepsis of any cause

19
Q

Which type of lymphocyte is most likely to be noted in the total lymphocyte count?

A

T-cell deficiencies

20
Q

What causes pseudothrombocytopenia (platelet clumping/satellitosis)

A

EDTA artifact (1% of hospitalized patients)

21
Q

What should you do if a p.smear shows platelet clumping/satellitosis?

A

recollect in Citrate or Acid-Citrate-Dextrose (ACD)

22
Q

What syndromes are associated with large/variably sized platelets?

A
  • Bernard-Soulier
  • May-Hegglin

*more commonly indicate increased marrow production

23
Q

Where do you see small platelets?

A
  • Glanzmann thrombasthenia

- production defects

24
Q

What is the most common cause of thrombocytopenia in children?

A

Immune Thrombocytopenic Purpura (ITP)

25
Q

ITP is caused by autoantibodies vs what? (4)

A
  • GPIIb
  • GPIIIa
  • GPIb
  • GPV
26
Q

Thrombotic Thrombocytopenia Purpura (TTP) pentad.

A
  • Thrombocytopenia
  • Microangiopathic hemolytic anemia
  • Neurologic abnormalities
  • Renal dysfunction
  • Fever
27
Q

TTP:

  • P.smear
  • Lactate Dehydrogenase
A
  • Numerous Schistocytes

- Very high LD

28
Q

Familial (chronic relapsing) TTP is caused by an inherited deficiency of what?

A

ADAMTS-13

29
Q

What is the function of ADAMTS-13?

A

cleaves large vWF multimers into smaller ones

30
Q

What is treatment for TTP?

A

Daily plasmapheresis with replacement of FFP

31
Q

T/F: Platelet transfusions are contraindicated in TTP.

A

True

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