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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
Q

What is the difference between plasma and serum?

A

Plasma:no RBC
Serum:no RBC or fibrinogen

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26
Q

What is Chronic Granulomatous Disease?

A

NADPH oxidase deficiency -> recurrent Staph/Aspergillus infections (Nitroblue Tetrazolium stain negative)

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27
Q

What does MPO deficiency cause?

A

Catalase + infections

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28
Q

What is Chediak Higashi?

A

Lazy lysosome syndrome: lysosomes are slow to fuse around bacteria

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29
Q

What organ can make RBCs if the longbones are damaged?

A

Spleen => splenomegaly

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30
Q

What causes a shift to the right in the Hb curve?

A

“All CADETs face right”

^CO2
Acid/Altitude
2,3-DOG
Exercise
Temp
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31
Q

How does CO poison Hb?

A

Competitive inhibitor of O2 on Hb => cherry red lips, pinkish skin hue

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32
Q

How does Cyanide poison Hb?

A

Non competitive inhibitor of O2 on Hb => almond breath

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33
Q

What is MetHb?

A

Hb w/ Fe+3

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34
Q

What is Acute Intermittent Porphyria?

A

^Porphyrin, urine delta-ALA, porphobilinogen => abdominal pain, neuropathy, red urine

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35
Q

What is Porphyria Cutanea Tarda?

A

Sunlight=> skin blisters w/porphyrin deposits,

Woods lamp= orange-pink

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36
Q

What is Erythrocytic Protoporphyria?

A

Porphyria cutanea tarda in a baby

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37
Q

What is Sickle cell disease?

A

Homozygous HbS: (BGlut6->Val) vaso-occlusion, necrosis, dactylitis (painful fingers/toes) at 6mo, protects against malaria

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38
Q

What is Sickle cell trait?

A

Heterozygous HbS => painless hematuria, sickle with extreme hypoxia (can’t be a pilot, fireman, diver)

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39
Q

What is Hb C disease?

A

(BGlu6->Lys), still charged => no sickling

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40
Q

What is alpha-thalassemia?

A

1 deletion:normal
2 deletions “trait”: Microcytic anemia
3 deletions: Hemolytic anemia, Hb H=B4
4 deletions: hydrops fetalis, Hb Bart= Gamma 4

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41
Q

What is B thalassemia?

A

1 deletion “B minor”: ^HbA2 and HbF

2 deletions “trait/intermedia/major”: only HbA2, and HbF => hypoxia at 6 months

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42
Q

What is Cooley’s anemia?

A

See w/B thalassemia major (o HbA=>excess RBC production); baby making blood from everywhere=> frontal bossing hepatosplenomegaly, long extremities

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43
Q

What is Virchow’s triad?

A

Thrombosis risk factors:

1) Turbulent blood flow “slow”
2) Hypercoagulable “sticky”
3) Vessel wall damage “escapes”

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44
Q

What does acute hypoxia cause?

A

Shortness of breath

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45
Q

What does chronic hypoxia cause?

A

Clubbing of fingers/toes

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46
Q

What is intravascular hemolysis?

A

RBC destroyed in blood vv. -> low haptoglobin (bind free floating Hb)

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47
Q

What is extravascular hemolysis?

A

RBC destroyed in spleen (problem w/RBC membrane) => splenomegaly

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48
Q

What enzyme need lead (Pb)?

A

delta- ALA dehydrase

Ferrochelatase

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49
Q

What does EDTA bind?

A

X2+

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50
Q

What disease has a smooth philthrum?

A

Fetal alcohol syndrome

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51
Q

What disease has a long philthrum?

A

William’s

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52
Q

What disease has a sausage digits?

A

Pseudo-hypoparathyroidism, psoriatic arthritis

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53
Q

What disease has 6 fingers?

A

Trisomy 13

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54
Q

What disease has 2 joined thumbs?

A

Diamond-Blackfan

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55
Q

What disease has painful fingers?

A

Sickle cell disease

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56
Q

What are the Microcytic Hypochromic anemias?

A 
"FAST Lead"
Fe deficiency
Anemia of chronic disease
Sideroblastic anemia
alpha-Thalasemmia
B-Thalasemmia
Pb poisoning
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57
Q

Fe deficiency

A

^ TIBC, menses, GI bleed, koilonychia

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58
Q

Anemia of Chronic Disease

A

decrease TIBC

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59
Q

Sideroblastic Anemia

A

decrease Delta-ALA synthase, blood transfusions

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60
Q

alpha thalassemia

A

AA, Asians, (Chromosome 16 deletion)

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61
Q

B Thalassemia

A

Mediterraneans (Chromosome 11 point mutation)

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62
Q

Pb poisoning

A

decrease delta-ALA dehydrogenase, decrease ferrochelatase, x-ray blue line, eating old paint chips

63
Q

What are the Megaloblastic Anemias?

A

Vit B12 deficiency
Folate deficiency
Alcohol

64
Q

Vit B12 deficiency

A

Tapeworms, vegans, type A gastritis, pernicious anemia

65
Q

Folate deficiency

A

old food, glossitis

66
Q

Alcohol

A

Fetal alcohol syndrome: smooth philthrum, stuff doesn’t grow

67
Q

What are the Intravascular Hemolytic Anemias?

A

IgM

G-6PD deficiency
Cold autoimmune

68
Q

G6PD deficiency

A

Sulfa drugs, moth balls, fava beans, sudden drop in Hb

69
Q

Cold autoimmune

A

Mononucleosis, mycoplasma infections, RBC agglutination

70
Q

What are the Extravascular Hemolytic anemias?

A

IgG

Spherocytosis
Warm autoimmmune
Paroxysmal cold autoimmune
Sickle cell anemia

71
Q

Spherocytosis

A

Defective spherin or ankyrin, + osmotic fragility test

72
Q

Warm autoimmune

A

Anti-Rh Ab, dapsone, PTU, anti-malarias, sulfa drugs

73
Q

Paroxysmal cold autoimmune

A

Bleeds after cold expossure, Donath-Landsteiner Ab

74
Q

Sickle Cell Anemia

A

Crew haircut x-ray, avascular necrosis of femur, short fingers

75
Q

What are the Production Anemias?

A

Diamond-Blackfan

Aplastic Anemia

76
Q

Diamond-Blackfan

A

No RBCs, 2-joined thumbs

77
Q

Aplastic Anemia

A

Pancytopenia, autoimmune, benzene, AZT, CAM, radiation

78
Q

What is the Basophilic Stippling?

A

Lots of immature cells, ^mRNA (Pb poisoning)

79
Q

What is a Bite cell=Basket cell?

A

Unstable Hb inclusions (G6-PD deficiency)

80
Q

What is a Burr cell=Echinocyte?

A

Pyruvate kinase deficiency, Liver dz, Post-splenectomy

81
Q

What is Cabot’s ring body?

A

Vit B12 deficiency, Pb poisoning

82
Q

What is a Doehle body?

A

PMN leukocytosis (infection, steroids, tumor)

83
Q

What is a Drepanocyte?

A

Sickle cell anemia

84
Q

What is a Helmet cell?

A

Fragmented RBC (Hemolysis: DIC, HUS, TTP)

85
Q

Whats a Heinz body?

A

Hb precipitates and sticks to cell membranes (G-6PD deficiency)

86
Q

What is a Howell-Jolly body?

A

Spleen or bone marrow should have removed nuclei fragments (hemolytic anemia, spleen trauma, cancer)

87
Q

What is a Pappenheimer body?

A

Fe ppt inside cell (sideroblastic anemia)

88
Q

What is a Pencil Cell=Cigar cell?

A

Fe deficiency anemia

89
Q

What is a Rouleaux formation?

A

Multiple myeloma

90
Q

What is a Schistocyte?

A

Broken RBC (DIC, artificial heart valves)

91
Q

What is a Sideroblast?

A

Macrophages pregnant w/Fe (genetic or multiple transfusions)

92
Q

What is a Spherocyte?

93
Q

What is a Spur cell= Acanthocyte?

A

Lipid bilayer dz

94
Q

What is a Stomatocyte?

95
Q

What is a target cell=codocyte?

A

Less Hb (Thallasemias or Fe deficiency)

96
Q

What is a tear drop cell = dandrocyte?

A

RBCs squeezed out of marrow (hemolytic anemia. bone marrow cancer)

97
Q

What is a clotting cascade?

A

How you stop bleeding

98
Q

What do platelet problems cause?

A

bleeding from skin and mucosa

99
Q

What do clotting problems cause?

A

bleeding into cavities

100
Q

What causes increased PTT and bleeding time?

A

von Willebrand disease and Lupus

101
Q

What is Bernard-Soulier?

A

baby w/bleeding from skin and mucosa, big platelets (low GP1b)

102
Q

What is Glanzmann’s?

A

baby w/ bleeding from skin and mucosa (low GP2b3a)

103
Q

How does Factor 1 deficiency present?

A

Unbilical stump bleeding (1st time baby has to stabilize a clot)

104
Q

What is Factor V Leiden?

A

Protein C can’t break down factor 5=> more clots

105
Q

How does von Willerbrand Disease present?

A

Heavy menstrual bleeding

106
Q

What are the types of VWD?

A 
Type 1 (AD): decreases VWF production
Type 2(AD): decreases VWF activity (+Ristocetin aggregation test)
Type 3(AD): No VWF
107
Q

What is Hemophilia A?

A

Defective factor 8 ( bleed into cavities (head, abdomen, etc)

108
Q

What is Hemophilia B?

A

Factor 9 deficiency=> bleed into joints (knee, etc)

109
Q

What diseases have low LAP?

110
Q

What has high LAP?

A

Leukemoid reaction

111
Q

What is the difference between acute and chronic leukemia?

A

Acute: started in bone marrow, squeezes RBC out of marrow

Chronic: started in periphery, not constrained => will expand

112
Q

What is the difference between myeloid and lymphoid leukemias?

A

Myeloid: ^RBC, WBC, platelets, MP (decrease lymphoid cells) => bone marrow biopsy

Lymphoid: ^NK, T, B cells (decrease myeloid cells) => do lymph node biopsy

113
Q

What defines ALL?

A

<15 y/o males, bone pain, PAS stain +, TdT +

114
Q

What defines AML?

A

15-30 y/o males, Sudan Stain, Auer rods

115
Q

What defines CML?

A

30-50 y/o females, t (9,22) “philadelphia chromosome”, bcr-abl, decrease LAP

116
Q

What defines CLL?

A

> 50 y/o males w/lymphadnopathy, “soccer ball”, nuclei, smudge cells

117
Q

What defines Hodgkin’s lymphoma?

A

EBV, may have Reed-Sternberg cells

118
Q

What are the B cel Non-Hodgkins lymphomas?

A

Follicular: t(14,18), bcl-2
Burkitt: t(8,14), c-myc, starry sky MP
-American kids: abdominal mass
-African kids: jaw mass

119
Q

What are the T cell Non-hodgkins lymphomas?

A

Mycosis Fungoides: total body rash

Sezary syndrome: cerebreform cells

120
Q

What is Polycythemia Rubra Vera?

A

Hct>60%, decrease Epo, Budd-Chiari, plethora “pruritis after bathing”

121
Q

What is Essential Thrombocythemia?

A

Very high platelets, stainable Fe, decrease c-mpl

122
Q

What is Myelofibrosis?

A

Megakaryocytes, fibrotic marrow=> teardrop cells, extramedular hematopoiesis

123
Q

What are plasma neoplasm?

A

Produces lots of Ab

124
Q

What is Waldenstrom Macroglobulinemia?

A

IgM, hyperviscous

125
Q

What is Monoclonal Gammopathy of Undetermined Significance?

A

Old person w/ gamma spike

126
Q

What is multiple myeloma?

A

Serum M prot (IgG), urine Bence-Jones protein, rouleaux, punched out lesions

127
Q

What is Heavy Chain Disease?

128
Q

What is Hystocytosis X?

A

Kid w/ eczema, skull lesions, diabetes insipidus, exophthalmos

129
Q

What does the Coombs test tell you?

A

Ab involved

130
Q

What does the direct Coombs tes tell you?

131
Q

What is type and cross?

A

You know you can use that blood, save it for specific pt

132
Q

What is type and match?

A

Type it and wait

133
Q

What is forward typing?

A

Uses Ab to detect Ag “ Fabulous”

134
Q

What is backward typing?

A

Uses Ag to detect Ab

135
Q

What does blood type A tell you?

A

Have the A antigen

136
Q

What does blood type O tell you?

A

Have no antigens, universal donor

137
Q

What does bloos type AB tell you?

A

Have both antigens, universal recipient

138
Q

What does Rh + tell you?

A

Has D antigen

139
Q

What does Rh- tell you?

A

Does not have D antigen

140
Q

What is Hemolytic Disease of the Newborn?

A

Rh -Mom’s placenta tears, 100 cc baby’s blood sees Mom/produces Ab, attack fetus

141
Q

What is RHOGAM?

A

Anti-D IgG

142
Q

When do you give RHOGAM?

A

1st dose: 28 wk gestation (of 2nd child)

2nd dose: 72 hrs post delivery (Rh + baby)

143
Q

What is the most common transplant?

144
Q

What is a Syngenic transplant?

A

Twin to twin

145
Q

What is an Autograft?

A

Self to Self transplant

146
Q

What is an Allograft?

A

Human to Human transplant

147
Q

What is a Xenograft?

A

1 species to another species

148
Q

What is a Hyperacute rejection?

A

within 12 hrs (preformed Ab)

149
Q

What is Acute rejection?

A

4 days to years later (tcells, MP)

150
Q

What is a Chronic rejection?

A

> 7 days (fibroblast)

151
Q

What is a Graft vs Host disease?

A

Bone marrow transplants reject (T k, MP)

152
Q

What are Immunoprivileged sites?

A

No lymphatic flow=> no Ag=> easy to transplant (brain, cornea, thymus, testes)

153
Q

What is INR?

A

Measured PT/ Control PT

AM PP Clues (8 decks)

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