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AM PP Clues > Hematology > Flashcards

Hematology Flashcards

1
Q

What is a Neutrophil?

A

The phagocyte (has anti-microbials, most abundant)

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2
Q

What is a Eosinophil?

A

The parasite destroyer, allergy inducer

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3
Q

What is a Basophil?

A

The Allergy Helper (IgE receptor=> histamine release)

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4
Q

What is a Monocyte?

A

The Destroyer=> MP (hydrolytic enzymes, coffee-bean nucleus)

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5
Q

What is a Lymphocyte?

A

The Warrior=>T, B, NK cells

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6
Q

What is a Platelet?

A

The Clotter (no nuclei, smallest cells)

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7
Q

What is a Blast?

A

Baby Hematopoietic cell

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8
Q

What is a Band?

A

Baby Neutrophil

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9
Q

What does high WBC and high PMNs tell you?

A

Stress demargination

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10
Q

What does high WBC and <5% blasts tell you?

A

Leukemoid reaction, seen in burn patients (extreme demargination looks like leukemia)

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11
Q

What does high WBC and > 5% blasts tell you?

A

Leukemia

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12
Q

What does high WBC and bands tell you?

A

Left shift=> have infection

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13
Q

What does high WBC and B cells tell you?

A

Bacterial infection

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14
Q

What diseases have high eosinophils?

A

“NAACP”

Neoplasm
Allergy/ Asthma
Addisons disease (no cortisol -> relative eosinophilia
Collagen vascular disease
Parasites
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15
Q

What diseases have high monocytes (>15%)?

A

“STELS”

Syphilis: chancre, rash, warts
TB: hemoptysis, night sweats
EBV: teenager sick for a month
Listeria: baby who is sick
Salmonella: food poisoning
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16
Q

What do high retics (>1%) tell you?

A

RBC being destroyed peripherally

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17
Q

What do low retics tell you?

A

Bone marrow not working right (decrease production)

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18
Q

What is Poikilocytosis?

A

Different shapes

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19
Q

What is Anisocytosis?

A

Different sizes

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20
Q

What is the RBC lifespan?

A

120 days

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21
Q

What is the platelet lifespan?

A

8-10 days

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22
Q

What does -penia tell you?

A

Low levels (usually due to virus or drugs)

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23
Q

What does -cytosis tell you?

A

High levels

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24
Q

What soes -cythemia tell you?

A

High levels

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25
What is the difference between plasma and serum?
Plasma:no RBC Serum:no RBC or fibrinogen
26
What is Chronic Granulomatous Disease?
NADPH oxidase deficiency -> recurrent Staph/Aspergillus infections (Nitroblue Tetrazolium stain negative)
27
What does MPO deficiency cause?
Catalase + infections
28
What is Chediak Higashi?
Lazy lysosome syndrome: lysosomes are slow to fuse around bacteria
29
What organ can make RBCs if the longbones are damaged?
Spleen => splenomegaly
30
What causes a shift to the right in the Hb curve?
"All CADETs face right" ``` ^CO2 Acid/Altitude 2,3-DOG Exercise Temp ```
31
How does CO poison Hb?
Competitive inhibitor of O2 on Hb => cherry red lips, pinkish skin hue
32
How does Cyanide poison Hb?
Non competitive inhibitor of O2 on Hb => almond breath
33
What is MetHb?
Hb w/ Fe+3
34
What is Acute Intermittent Porphyria?
^Porphyrin, urine delta-ALA, porphobilinogen => abdominal pain, neuropathy, red urine
35
What is Porphyria Cutanea Tarda?
Sunlight=> skin blisters w/porphyrin deposits, | Woods lamp= orange-pink
36
What is Erythrocytic Protoporphyria?
Porphyria cutanea tarda in a baby
37
What is Sickle cell disease?
Homozygous HbS: (BGlut6->Val) vaso-occlusion, necrosis, dactylitis (painful fingers/toes) at 6mo, protects against malaria
38
What is Sickle cell trait?
Heterozygous HbS => painless hematuria, sickle with extreme hypoxia (can't be a pilot, fireman, diver)
39
What is Hb C disease?
(BGlu6->Lys), still charged => no sickling
40
What is alpha-thalassemia?
1 deletion:normal 2 deletions "trait": Microcytic anemia 3 deletions: Hemolytic anemia, Hb H=B4 4 deletions: hydrops fetalis, Hb Bart= Gamma 4
41
What is B thalassemia?
1 deletion "B minor": ^HbA2 and HbF | 2 deletions "trait/intermedia/major": only HbA2, and HbF => hypoxia at 6 months
42
What is Cooley's anemia?
See w/B thalassemia major (o HbA=>excess RBC production); baby making blood from everywhere=> frontal bossing hepatosplenomegaly, long extremities
43
What is Virchow's triad?
Thrombosis risk factors: 1) Turbulent blood flow "slow" 2) Hypercoagulable "sticky" 3) Vessel wall damage "escapes"
44
What does acute hypoxia cause?
Shortness of breath
45
What does chronic hypoxia cause?
Clubbing of fingers/toes
46
What is intravascular hemolysis?
RBC destroyed in blood vv. -> low haptoglobin (bind free floating Hb)
47
What is extravascular hemolysis?
RBC destroyed in spleen (problem w/RBC membrane) => splenomegaly
48
What enzyme need lead (Pb)?
delta- ALA dehydrase | Ferrochelatase
49
What does EDTA bind?
X2+
50
What disease has a smooth philthrum?
Fetal alcohol syndrome
51
What disease has a long philthrum?
William's
52
What disease has a sausage digits?
Pseudo-hypoparathyroidism, psoriatic arthritis
53
What disease has 6 fingers?
Trisomy 13
54
What disease has 2 joined thumbs?
Diamond-Blackfan
55
What disease has painful fingers?
Sickle cell disease
56
What are the Microcytic Hypochromic anemias?
``` "FAST Lead" Fe deficiency Anemia of chronic disease Sideroblastic anemia alpha-Thalasemmia B-Thalasemmia Pb poisoning ```
57
Fe deficiency
^ TIBC, menses, GI bleed, koilonychia
58
Anemia of Chronic Disease
decrease TIBC
59
Sideroblastic Anemia
decrease Delta-ALA synthase, blood transfusions
60
alpha thalassemia
AA, Asians, (Chromosome 16 deletion)
61
B Thalassemia
Mediterraneans (Chromosome 11 point mutation)
62
Pb poisoning
decrease delta-ALA dehydrogenase, decrease ferrochelatase, x-ray blue line, eating old paint chips
63
What are the Megaloblastic Anemias?
Vit B12 deficiency Folate deficiency Alcohol
64
Vit B12 deficiency
Tapeworms, vegans, type A gastritis, pernicious anemia
65
Folate deficiency
old food, glossitis
66
Alcohol
Fetal alcohol syndrome: smooth philthrum, stuff doesn't grow
67
What are the Intravascular Hemolytic Anemias?
IgM G-6PD deficiency Cold autoimmune
68
G6PD deficiency
Sulfa drugs, moth balls, fava beans, sudden drop in Hb
69
Cold autoimmune
Mononucleosis, mycoplasma infections, RBC agglutination
70
What are the Extravascular Hemolytic anemias?
IgG Spherocytosis Warm autoimmmune Paroxysmal cold autoimmune Sickle cell anemia
71
Spherocytosis
Defective spherin or ankyrin, + osmotic fragility test
72
Warm autoimmune
Anti-Rh Ab, dapsone, PTU, anti-malarias, sulfa drugs
73
Paroxysmal cold autoimmune
Bleeds after cold expossure, Donath-Landsteiner Ab
74
Sickle Cell Anemia
Crew haircut x-ray, avascular necrosis of femur, short fingers
75
What are the Production Anemias?
Diamond-Blackfan | Aplastic Anemia
76
Diamond-Blackfan
No RBCs, 2-joined thumbs
77
Aplastic Anemia
Pancytopenia, autoimmune, benzene, AZT, CAM, radiation
78
What is the Basophilic Stippling?
Lots of immature cells, ^mRNA (Pb poisoning)
79
What is a Bite cell=Basket cell?
Unstable Hb inclusions (G6-PD deficiency)
80
What is a Burr cell=Echinocyte?
Pyruvate kinase deficiency, Liver dz, Post-splenectomy
81
What is Cabot's ring body?
Vit B12 deficiency, Pb poisoning
82
What is a Doehle body?
PMN leukocytosis (infection, steroids, tumor)
83
What is a Drepanocyte?
Sickle cell anemia
84
What is a Helmet cell?
Fragmented RBC (Hemolysis: DIC, HUS, TTP)
85
Whats a Heinz body?
Hb precipitates and sticks to cell membranes (G-6PD deficiency)
86
What is a Howell-Jolly body?
Spleen or bone marrow should have removed nuclei fragments (hemolytic anemia, spleen trauma, cancer)
87
What is a Pappenheimer body?
Fe ppt inside cell (sideroblastic anemia)
88
What is a Pencil Cell=Cigar cell?
Fe deficiency anemia
89
What is a Rouleaux formation?
Multiple myeloma
90
What is a Schistocyte?
Broken RBC (DIC, artificial heart valves)
91
What is a Sideroblast?
Macrophages pregnant w/Fe (genetic or multiple transfusions)
92
What is a Spherocyte?
Old RBC
93
What is a Spur cell= Acanthocyte?
Lipid bilayer dz
94
What is a Stomatocyte?
Liver dz
95
What is a target cell=codocyte?
Less Hb (Thallasemias or Fe deficiency)
96
What is a tear drop cell = dandrocyte?
RBCs squeezed out of marrow (hemolytic anemia. bone marrow cancer)
97
What is a clotting cascade?
How you stop bleeding
98
What do platelet problems cause?
bleeding from skin and mucosa
99
What do clotting problems cause?
bleeding into cavities
100
What causes increased PTT and bleeding time?
von Willebrand disease and Lupus
101
What is Bernard-Soulier?
baby w/bleeding from skin and mucosa, big platelets (low GP1b)
102
What is Glanzmann's?
baby w/ bleeding from skin and mucosa (low GP2b3a)
103
How does Factor 1 deficiency present?
Unbilical stump bleeding (1st time baby has to stabilize a clot)
104
What is Factor V Leiden?
Protein C can't break down factor 5=> more clots
105
How does von Willerbrand Disease present?
Heavy menstrual bleeding
106
What are the types of VWD?
``` Type 1 (AD): decreases VWF production Type 2(AD): decreases VWF activity (+Ristocetin aggregation test) Type 3(AD): No VWF ```
107
What is Hemophilia A?
Defective factor 8 ( bleed into cavities (head, abdomen, etc)
108
What is Hemophilia B?
Factor 9 deficiency=> bleed into joints (knee, etc)
109
What diseases have low LAP?
CML, PNH
110
What has high LAP?
Leukemoid reaction
111
What is the difference between acute and chronic leukemia?
Acute: started in bone marrow, squeezes RBC out of marrow Chronic: started in periphery, not constrained => will expand
112
What is the difference between myeloid and lymphoid leukemias?
Myeloid: ^RBC, WBC, platelets, MP (decrease lymphoid cells) => bone marrow biopsy Lymphoid: ^NK, T, B cells (decrease myeloid cells) => do lymph node biopsy
113
What defines ALL?
<15 y/o males, bone pain, PAS stain +, TdT +
114
What defines AML?
15-30 y/o males, Sudan Stain, Auer rods
115
What defines CML?
30-50 y/o females, t (9,22) "philadelphia chromosome", bcr-abl, decrease LAP
116
What defines CLL?
>50 y/o males w/lymphadnopathy, "soccer ball", nuclei, smudge cells
117
What defines Hodgkin's lymphoma?
EBV, may have Reed-Sternberg cells
118
What are the B cel Non-Hodgkins lymphomas?
Follicular: t(14,18), bcl-2 Burkitt: t(8,14), c-myc, starry sky MP -American kids: abdominal mass -African kids: jaw mass
119
What are the T cell Non-hodgkins lymphomas?
Mycosis Fungoides: total body rash | Sezary syndrome: cerebreform cells
120
What is Polycythemia Rubra Vera?
Hct>60%, decrease Epo, Budd-Chiari, plethora "pruritis after bathing"
121
What is Essential Thrombocythemia?
Very high platelets, stainable Fe, decrease c-mpl
122
What is Myelofibrosis?
Megakaryocytes, fibrotic marrow=> teardrop cells, extramedular hematopoiesis
123
What are plasma neoplasm?
Produces lots of Ab
124
What is Waldenstrom Macroglobulinemia?
IgM, hyperviscous
125
What is Monoclonal Gammopathy of Undetermined Significance?
Old person w/ gamma spike
126
What is multiple myeloma?
Serum M prot (IgG), urine Bence-Jones protein, rouleaux, punched out lesions
127
What is Heavy Chain Disease?
^IgA
128
What is Hystocytosis X?
Kid w/ eczema, skull lesions, diabetes insipidus, exophthalmos
129
What does the Coombs test tell you?
Ab involved
130
What does the direct Coombs tes tell you?
In serum
131
What is type and cross?
You know you can use that blood, save it for specific pt
132
What is type and match?
Type it and wait
133
What is forward typing?
Uses Ab to detect Ag " Fabulous"
134
What is backward typing?
Uses Ag to detect Ab
135
What does blood type A tell you?
Have the A antigen
136
What does blood type O tell you?
Have no antigens, universal donor
137
What does bloos type AB tell you?
Have both antigens, universal recipient
138
What does Rh + tell you?
Has D antigen
139
What does Rh- tell you?
Does not have D antigen
140
What is Hemolytic Disease of the Newborn?
Rh -Mom's placenta tears, 100 cc baby's blood sees Mom/produces Ab, attack fetus
141
What is RHOGAM?
Anti-D IgG
142
When do you give RHOGAM?
1st dose: 28 wk gestation (of 2nd child) | 2nd dose: 72 hrs post delivery (Rh + baby)
143
What is the most common transplant?
Blood
144
What is a Syngenic transplant?
Twin to twin
145
What is an Autograft?
Self to Self transplant
146
What is an Allograft?
Human to Human transplant
147
What is a Xenograft?
1 species to another species
148
What is a Hyperacute rejection?
within 12 hrs (preformed Ab)
149
What is Acute rejection?
4 days to years later (tcells, MP)
150
What is a Chronic rejection?
>7 days (fibroblast)
151
What is a Graft vs Host disease?
Bone marrow transplants reject (T k, MP)
152
What are Immunoprivileged sites?
No lymphatic flow=> no Ag=> easy to transplant (brain, cornea, thymus, testes)
153
What is INR?
Measured PT/ Control PT

AM PP Clues (8 decks)

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