Friday Heme 2 Flashcards
CO monoxide binds to Hb w super high ___
carboxyhemoglobin should be __
this dec O2 carrying capacity and __
amount dissolved in plasma is __ reflected by PaO2
this causes __ shift of O2 dissociation curve, so O2 is not __ to tissues
Methemoglobinemia formed when Fe 2+ in __ is oxidized to Fe 3+
results of drugs like D/N or __ def and hemoglobinopathies
Most dangerous cause of iron deficiency is __ loss
most __ women are low
old men/women should have __ levels
if not, run __ studies w C__
affinity high content normal leftward delivered
heme
Dapsone, nitrites, enzyme
blood
premenopausal
normal
iron, colonoscopy
N__ technique used to detect mRNA to assess for gene expression
in a___, exons of premRNA are reconnected in multiple ways during post translation procesing
as such, one gene encodes __ proteins
COX1 plays role in _ prodxn and __ tract
COX2 is preffered at sites of __
NSAID AE of gi ulcers/bleeding due to __
both are expressed in __ tissues, w blockage causing fluid retention
COX2 may also aid in prodxn of __ in vasc endothelial/smooth muscle cells
inc risk of __ events
northern blot
alternative splicing
many
platelet, GI inflammation COX1 Prostacyclin cv
Carcinoid tumors form in the __ cells of the intestinal mucosa
by going to the liver, products are __ and prevented from having an effect
if metastasis occurs to __ or beyond, can release __ and result in clinical manifestations
persistent fluctuating LAD in elderly pt most likely has \_\_ lymphoma mc indolent \_\_ course \_\_ and wanes LN are \_\_ enlarged Histology shows \_\_/\_\_ follicle cells
enterochromaffin
metabolized
liver, serotonin
follicular NHL waxes painelss cleaved/noncleaved
DLBCL presents w rapidly enlarging __ or symptomatic mass
__ ring shows oropharyngeal lymphoid tissue, and __ tract is usually involved
usually have __ sx
__ cell leukemia presents in elderly men
w S__ and p__
LAN are __
positive for __ stiaining
__ is cutaneous T cell lymphoma
CD4 t cells infiltrate the __/__ to form pautrier microabscesses
presents w __ similar to eczema or psoriasis
may see generalized __ of skin
nodal
Waldeyers
GI
B
hairy
splenomegaly, pancytopenia
normal
TRAP
mycosies fungoides
dermis/epidermis
rash
reddening
__ is used to amplify small regions of DNA
requires __ w target gene and __ regions to target
exact sequence is __ necessary
need thermostable __ and DNA triphosphates
first step is D__ at high temp
A__ w primers combine, as temp lowered
E__ w DNA Poly forming new strands
Factor __ deficiency is inherited AR
leads to clot __
pt has __ bleeding
PCR
DNA sequence, flanking
not
DNA polymerase
denaturing
annealing
elongation
13
instability
delayed
Uremic platelet dysfxn has normal __/__/__ but inc bleeding time
in __, platelet count is down w inc bleeding time
__ admin results in inc PTT and everything else normal
Warfarin use has inc __/__ and normal _/__
vWF binds to __ on subendothelial collagen, allowing platelet aggregation
also is protective carrier for __
PT, PTT, platelets
ITP
heparin
PT/PTT, platelets/bleeding time
Gp1B
factor 8
in pt w OSA, __ cells in renal cortex sense hypoxia
release __ which goes to bone marrow receptors
also seen in other __ states
intramuscular bleeding, hemorrhage into joints, delayed/prolonged bleeding w minor procedures prbably has ___
tx w factor __
also __ to inc circulating factor 8/vWF
pt w fat soluble vitamin malabsorption and bleeding probs think __ deficiency
peritubular cells
EPO
hypoxic
X linked hemophilia a
replacement
desmopressin
VK
__ used to tx anaerobic gram neg rod and aerobic gram pos cocci
SE is _ coliitis
__ causes Oto/nephro/neurotoxicity
Metro SE include __ and __
Cloramphenicol SE include __ and dose independent __ anemia
suppresses bacterial protein synthesis by inhibiting __ subunit
Clindamycin
pseudomembrane
gentamicin
GI/neurologic
pancytopenia, aplastic
50s
Aplastic anemia is due to \_\_ def (CD34) can be A or I or D causes drugs like C/C/S or exposure to \_\_/\_\_ presents w A_, T\_\_\_ and :\_\_
diagnosis shows __ bone marrow of fat/stromal cells
shows low r__ count
G__ is used to tx CMV
interferes w human __ synthesis and SE include neutro/leuko/thrombopenia
TMPSMX inhibits enzymes for __ synthesis
SE is __ suppression
antiretrovirl Z__ also inhibs human DNA polymerase w risk of _ suppression
HSC autoimmune, infectious, drugs carbamezpine, chloramphenicol, sulfonamides radiation/toxin anemia, thrombocytopnia, leukopenia
hypocellular
reticulocyte
ganciclovir
DNA
THF
bone marrow
zidovidine
bone marrow
Tb meds R\_\_ inhibits bacterial DNA dep RNA poly SE include \_\_ and rash w \_\_ body fluids/cytopenia I\_\_ inhibs mycolic acid synth Pyrinazimide SE include H/H E\_\_\_ inhibits arabinosyl transferase
F__ is anticancer drug producing electrolyte abnorms
antiretroviral D__ can result in panc
rifampin GI, orange isoniazid Hepatotox, hyperuricemia ethambutol
foscarnet
Didanovine
S__ can be formed w narrowing of vasc spaces as seen in DIC, HUS, TTP
Hemolytic anemia has inc indirect __, hemoglobin__/__
haptoglobin binds __ and promotes uptake by RES
w lots of Hb in blood, haptoglobin __
__ blot is used to detect protein
target proteins separated by __
transferred to membrane and probed w __ for protein
membrane is washed and a second __ antibody is added
process is similar to __
schistocytes bilirubin nemia, uria Hb dec
western
gel electrophoresis
antibody
marked
elisa
__ blot analyzes mRNA
__ blot analyzes DNA
__ array analyzes DNA adn is labeled w fluorescent tag corresponding to __ produced
__ blot analzyes DNA binding proteins binding to specific oligonucleotide probes
inc erythropoesis pushes __ into blood
these are __ RBC that are blue due to __
also have no __
northern
southern
microarray
SW
reticulocytes
immature, rRNA
nucleus
\_\_/\_\_ bind C1 to activate classic complement \_\_ is preferred due to pentameric shape C1 binds the \_\_ region near the hinge light chain is on \_\_ of antibody chains held together by \_\_ linkages bottom of \_\_ holds IgA or IgM together
PPP has oxidative __ rxns and nonoxidative reversible rxns
Trans__/__ can produce glycolytic intermediates for __ generation
can fxn in reverse to form _
from F6P via nonoxidative rxn
__ and __ are thus irreversible enzymes to form NADPH
IgG/IgM IgM Fc outside disulfide Fc region
irreversible
ketolase/aldolase
ATP
R5P
G6PD, and glutathione reductase
HUS is __ EHEC
transferred from __ beef, __ contact, or taking in __ water
develops after __ of infection
toxicity of cyanide depends on ability to bind __ form of iron
this inhibs __ oxidase in mito, stopping OP
sx include __ skin, tachypnea, HA, and tachycardia
can have S_ and __ collpase
labs show __ & narrowed __ gradient
administer inhaled __ to oxidize ferrous iron to ferric form
this forms M__ which can bind cynaide
also H and sodium __ are antidotes
O157H7
undercooked, family, sewage
treatment
Ferric Fe3+ cytochrome C red seizure, cardio severe LA, AV O2
aryl nitrate
methemoglobinemia
hydroxycobalamin, thiosulfate
in urero, fetus produces G__ hb which is __ and __
next is HbF in last months of __
HbA synthesis starts in __ month of gestation
B thalassemia does not manifest in early life bc of prodxn of __
as this wanes, __ dominates and precipitates
Hairy cell leukemia infiltrates the __ and cause fibrosis
P and dry tap form
have massive __ w LUQ pain, fatigue, weak, recurrent infections
look for lymphs w __
AML does not cause __
Heterophile antibodies are seen in __ infection
gower, Z2E2
gestation
last
HbF
HbA
BM
pancytopenia
splenomegaly
cytoplasmic projections
splenomegaly
EBV
AML has P__ and greater than 20% __ in bone marrow
large unnucleated cells are __ in bone marrow, likely for AML
leuks usually
mature lymphs/granulocytes indicates __/__
HL presets w __ and RS cells w 2+ nuclei
Hb electrophoresis w HbF>HbA>HbS has __ dz
usually __ but may get hematuria, pripaism, UTI
relative protection from __
reticulocyte count is __, normal __/__
pancytopenia, myeloblasts
blasts
elevated
CML/CLL
mass
Sickle cell trait
asx
malaria
normal, RBC/Hb
M\_\_ is Zn containing enzyme to degrade ECM/BM facilitate BM \_\_ tumor cells detach by downregulating \_\_ adhere to BM via inc L\_\_ then \_\_ occurs
schistocytes can occur via __ or mechanical damage
unlike DIC, coag system is not activated in __
EPO def results in __/__ anemia
Leukoerythroblastic peripheral smears have nucleated __ and immature white cells
bone marrow is replaced by __ or cancer
characteristic __ cells
metalloproteases invasion e cadherin laminins invasion
MHA
HUS-TTP
normochromic/normocytic
RBC
fibrosis
teardrop
smear w small cells w dark nuclei in center of cytoplasm indicates L__ from lymph tissue
in XLR pattern, affected males always have __ sons and __ daughters
in XLD, one parent is __
affected male always produces __ daughters
if all offspring of mother has a condition, inheritance is _
lymphocytes
normal, carrier
always, affected
mitochondrial
Iron def anemia more likely to be seen in teenage girl w M__ and growth
or in __ diet
process- dec \_\_ iron (low ferritin/hemosiderin) low serum F\_\_ inc \_\_ and Transferrin dec serum \_\_/\_\_/ H/M rbc
FH of sarcoma, leukemia, adrenal, breast, brain cancer has __ syndrome
mutation in __
menses
vegetarian
bm
ferritin
TIBC
iron/Hb
Li fraumeni
tp53
__ syndrome asssc w colon, endometrial, ovarian ca
_ assc w colorectal cancer, desmoid/osteomas and brain tumors
B12 def affects __/__ column of spinal cord
MCV greater than __ is always suggestive of B12/folate def
megaloblasts can be seen in __ dz, hypo__ and alcoholic liver dz
HNPCC
FAP
posterior, lateral
110
liver, thyroid
Sickle cell disease may produce __ gallstones
__ pain w vasoocclusive crises
repeated infarct leads to __ of spleen by late childhood
splenic __ occurs during sequestration
Hb is __ and spleen __
pt w SCD or hemolytic anemia has inc __ req due to inc erythrocyte turnover
pigmented bone atrophy congestion inc, large
folate
chronic myeloproliferative disorders caused overprodxn of __ cells
Primary myelofibrosis caused by atypical __ hyperplasia in fibroblast prodxn
marrow is __ w HSM
__ shaped RBC form
usually due to mutations in __
this upregulates __ to nucleus
can tx w JAK inhib R__
__ is lymphoproliferative do of B cells
smear shows __ cells w lymphocytosis
inc __ expresion
Mantle cell lymphoma has __ overexpression
myeloid megakaryocytic hypocellular teardrop JAK2, STAT ruxolitinib
CLL
smudge
BCL2
cyclin d1
Essential thrombocytosis has __ and __ sx
thrombo__ and megakaryocitc hyperplasia
PV has pruritis, inc __ mass, erythrocytosis and __
Primary myelofibrosis has severe fatigue and __ w bm fibrosis
all caused by _ mutation
CML has b sx w and lymphocytosis w marked __ shift
hemorrhagic, thrombotic cytosis RBC, thrombocytosis HSM JAK2
left
T cells produced in __ and migrate to thymus
Pro T cells arive and are __
w TCR gene arrangement, expression of __/__ occurs w fxnal TCR
__ selection occurs when T cells w TCR bind to self MHC survive
occurs in thymic __ and involves interraction w thymic __ epithelial cells
Neg selection occurs when TCR bind w high affinity to self __ or __
occurs in thymic __ w interraction to thymic medullary __ and dendritic cells
bone marrow double neg CD4/CD8 pos cortex cortical
antigen/MHC
medulla
epithelial
Affinity __ is process of enhancing __ region antigen binding
occurs after __ binds to membrane bound Ig or naive B cell
migrates to __
produces new Ig w __ affinity
microvascular thrombi is patho mech for __
leads to low __
__ abnorms result in Hereditary sphero/ellipto/stomatocytosis
maturation hypervariable antigen LN enhanced
MHA
platelets
cytoskeleton
__ is a TK related to EGFR
seen in __/__ cancers
ERB b2
breast/ovarian
