Hematology Flashcards by Mohab sha

Which type of leukemia are there rapid increases in immature blood cells, rapid progression and accumulation of the malignant cells over weeks or months, Immediate treatment is required (hospitalized immediately), & Most common forms of leukemia in children

Acute leukemia

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Hem-
-emia
A-, An-
-ic
-ia
-rhage
-lysis
-plasty
Cyt-
-osis
Chroma-
Leuk-
Eryth-
-penia
-oma
Thromb-
-cytosis

Blood
Blood condition
Without
Pertaining to
Condition
Discharge
Cell membrane rupture
Make
Cell
Disease
Color
White
Red
Lack
Tumour
Clot
Slight increase

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Which term refers to the cells that help carry oxygen to the tissues, that are produced in bone marrow?

What occurs to these cells when we have a problem without bone marrow?

& how else is the # of said cells is affected?

Erythrocytes (Red blood cells)
- A reduction in the # of RBC occurs
-Through acute or chronic hemorrhages (excessive bleeding)

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(Normal values) What is the normal level range of the total amount of hemoglobin in peripheral blood?

12.0-16.0 g/dl

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(Normal values) What is the normal level range of the total amount of platelets in blood?

130,000-400,000

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(Normal values) What is the normal level range of the total amount of RBCs in blood?

4.2-6.1

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(Normal values) What is the normal level range of the total amount of WBCs in blood?

3.5-12 10⁹/L

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Which term refers a condition in which you lack enough healthy red blood cells to carry adequate oxygen to your body’s tissues?

Anemia

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(Anemia) What is the normal morphologic classification of RBCs?

Normocyte normochromic

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(Anemia) List the morphological classifications of RBCs that characterize based on size & shape?

Macrocytes, normocytes, & microcytes

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(Anemia) List the morphological classifications of RBCs that characterize based on colour?

Hyperchromic, normochromic, & hypochromic

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(Etiology of anemia) List the possible causes etiologically that can cause anemia & explain why

Blood loss: Due to hemorrhage, such as internal or external bleeding
Increased destruction of RBCs: Also called hemolytic, where RBCs are ruptured
Decreased production of RBCs: Could be due to nutritional deficiencies, such as a lack of iron, protein, vitamin B12+, needed to form hemoglobin

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(Etiology of anemia) What are some common signs & symptoms of anemia?

Fatigue, weakness, dyspnea, & pale colour

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(Symptoms of Anemia) Explain why an individual might experience the common signs & symptoms of anemia?

Fatigue: Less energy due to low O2
Weakness: Due to low O2
Dyspnea: Due to lack of oxygen delivery to our cells, where the body compensates by increasing rate of breathing & rate of cardiac cycle
Pale colour: Due to part of our normal skin colour coming from our blood, when we have less hemoglobin it becomes pale

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(Symptoms of Anemia) List some other general symptoms of anemia

Loss of nerve fibres in spinal column paresthesia (numbness), balance disturbances, weakness, spasticity, reflex abnormalities – depending on cause of anemia

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(Loss or Destruction Anemia) What are the characteristics of a loss or destruction anemia?

We had healthy RBCs normal size, normal amount of hemoglobin, but through loss or destruction we have fewer in number of RBCs

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(Loss or Destruction Anemia) What are some examples of loss or destruction Anemia

Aplastic Anemia
Post Hemorrhagic Anemia
Hemolytic Anemia

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(Loss or Destruction Anemia) Which type of anemia refers to a condition that occurs when your body stops producing enough new blood cells?

Aplastic Anemia

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(Loss or Destruction Anemia) Which term refers to a condition that develops when you lose a large amount of blood quickly, which can be chronic due to internal ulcer or cancer?

What are the signs & symptoms when we los more than 20% of our blood (hypovolemia)?

Post hemorrhagic Anemia

Orthostatic hypotension, altered mental status, cool and/or clammy skin, tachycardia, and hyperventilation, & decreased pulse pressure

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(Loss or Destruction Anemia) Which term refers to where the RBCs are broken down & destroyed before their normal lifespan?

& what are the different factors it can be due to?

Hemolytic Anemias
- Can be because of an inherited disorder (Sickle Cell disease), an infection (E.coli, snake bites, & malaria), & hemolytic disease of newborn (Rh incompatibility)

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(Loss or Destruction Anemia - Hemolytic anemias) How does the hemolytic disease of newborns work?

An Rh negative mother has a baby with Rh positive father, where the1st baby has separate blood circulation & during delivery the blood mixes & the mother will develop antibodies against future Rh-positive babies. Babies are born with anemia & jaundice (due to destruction of hemoglobin which increases bilirubin)

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(Loss or Destruction Anemia - Hemolytic anemias) How do infections cause hemolytic anemia?

Caused by an infection of E.Coli, where you experience several days of diarrhea, which can lead to a low RBC count

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(Loss or Destruction Anemia - Hemolytic anemias) Which term refers to the condition that can occur when the small blood vessels in your kidneys become damaged and inflamed, where this damage can cause clots to form in the vessels & the clots clog the filtering system in the kidneys and lead to kidney failure, which could be life-threatening?

Hemolytic uremic syndrome (HUS)

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(Loss or Destruction Anemia - Hemolytic anemias) How do snake bites & malaria work to cause hemolytic anemia?

Snake bite: Can lead to prolonged or excessive bleeding due to venom
- Malaria: Malaria infection causes hemolysis of infected and uninfected erythrocytes which lowers the circulating volume of RBCs

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(Loss or Destruction Anemia - Hemolytic anemias) What are some symptoms of hemolytic anemia?

Abnormal paleness or lack of colour of the skin, yellowish skin, eyes, and mouth (jaundice), dark-coloured urine, fever, weakness, dizziness, confusion, & can't handle physical activity.

(Loss or Destruction Anemia - Hemolytic anemias) Which term refers to the removal, treatment, and return or exchange of blood plasma or components thereof from and to the blood circulation?

Plasmapheresis

(Inadequate Production Anemias) What are some examples of inadequate production anemias? & what are some of their morphological characteristics?

- Iron deficiency Anemia: Microcytic-Hypochromic Anemia - Pernicious Anemia: Macrocytic-Normochromic Anemia - Folate Deficiency Anemia: Macrocytic-Normochromic Anemia - Aplastic Anemia: Normocytic-Normochromic Anemia - Sickle Cell Anemia: Normocytic-Normochromic Anemia

(Inadequate Production Anemias) What is the most common anemia called? More common in women than men

Iron deficiency Anemia

(Inadequate Production Anemias) Which age group is iron deficiency anemia more prevalent in & what is the cause of said anemia? & why is it morphologically classified as Microcytic-hypochromic?

This anemia is high in children, especially undernourished children due to lack of nutrients. - Small erythrocytes & abnormally reduced amounts of hemoglobin

(Inadequate Production Anemias) What are the different causes of iron deficiency anemia? Where is iron stored?

- Can be caused by an inadequate intake of dietary iron or a chronic loss of blood - Can have insufficient iron delivered to bone marrow or impaired iron use within bone marrow - Women suffer Iron deficiency anemia in excessive menstrual bleeding - Iron is stored in our liver or spleen

(Inadequate Production Anemias) Aside from the common signs & symptoms of anemia, what are some other signs & symptoms of Iron Deficiency Anemia?

- Fingernails becoming brittle & spoon shaped (downward curve in finger nails) - Tongue papillae atrophy (bald fissured appearance), with soreness & burning (surface of tongue is shiny with less tone) - Angular stomatitis (sores in corners of mouth or cracks around the mouth)

(Inadequate Production Anemias) Which term refers to the rare & possibly fatal condition due to a lack of vitamin B12 (its needed for production of RBCS), usually caused by a lack of intrinsic factor for the absorption of vitamin B12? What is the cause of said deficit of the intrinsic factor?

Pernicious Anemia - Chronic atrophic gastritis: (1) Chronic inflammation of the gastric mucosa (where the body attacks the intrinsic factor protein responsible for absorbing Vit B12) (2) bacterial infection of H. pylori bacterium (Impaired absorption of Vit B12 dues to reduced stomach acid)

(Inadequate Production Anemias) What are some characteristics of pernicious anemia & what are the early & late symptoms?

- This type of anemia develops slowly (20-30 to develop) - Early signs & symptoms: Mood swings - Late signs & symptoms: Paresthesia (painless, tingling or numbness) of feet & fingers, difficulty walking (losing balance), loss of appetite & weight loss, & sore tongue (smooth & beefy red)

(Inadequate Production Anemias) Which term refers to the lack of folic acid in the blood? & why is folic acid important?

Folate deficiency anemia - Its essential for RNA & DNA synthesis within maturing erythrocyte, & we obtain all of our folic acid from our diet, with many foods now fortified with folate

(Inadequate Production Anemias) What are some signs & symtoms of folate deficiency anemia?

Similar to perinicious anemia - Painful ulcerations in mouth: Burning mouth syndrome - burning, scalding, or tingling feeling in the mouth - A painful, reddened tongue tender to the touch: You may first notice glossitis when it hurts to swallow (dysphagia) or speak, or you may spot the colour change when you examine your tongue because you feel it is swelling - watery diarrhea as well

(Inadequate Production Anemias) How is folate deficiency anemia prevented in pregnant women?

Prophylactic treatment in pregnancy: To prevent neural tube defects such as spina bifida

(Inadequate production Anemia) Which term refers to reduction in the production of RBCs, due to issues in bone marrow, which can be due to auto immune disease that doesn’t allow bone marrow or radiation, or chemotherapy? Also, some sources cite 50% some 65% of the diagnosed cases are idiopathic – (no known cause)- exposure to radiation or certain toxic chemicals, viral infections – hepatitis may also be a congenital from chromosome abnormalities Damage to bone marrow erythropoiesis This condition causes a reduction in all types of blood cells as well, including RBCS, WBCs, and platlets. What is this term called? And how is it diagnosed?

Aplastic anemia - Pancytopenia - Bone marrow biopsy

(Inadequate production Anemia) Which term refers to the abnormal production of hemoglobin S due to a genetic disorder, pretty much an inherited red blood cell disorder in which there aren't enough healthy red blood cells to carry oxygen throughout your body? What are the characteristics of sickled hemoglobin? & how might it be dangerous?

Sickle-cell anemia - The sickled hemoglobin is rigid and causes the RBC to be rigid and take on a sickled appearance. - This sickled cell will clog circulation as it is unable to pass through small vessels

(Inadequate production Anemia) The signs and symptoms of sickle cell anemia include: __ which is a crisis creating an occlusion (blockage) of blood vessels creating ischemia, and causing pain __ Is when the occulsion occurs in spleen, where draining vein of the spleen is obstructed & blood is pooled in the spleen. Describe the other symptom pertaining specifically to the life span of the sickle cell, otherwise known as chronic hemolytic anemia

- Vaso-occlusive crisis - Sequestration crisis - Reduction in the # of RBCS due to abnormal RBCs with hemoglobin type S not having the normal life spaan living 10-12 days only compared to 120 days.

(Other reasons for anemia) rheumatoid arthritis (chronic inflammation in joints lowers production of RBCs) & systemic lupus erythematosus (presence of antibodies against erythropoietin) are examples of? (HIV/AIDS) => shortened RBC survival (changes in production), impaired erythropoiesis, and impaired iron metabolism are examples of? And, list the other 2 reasons for anemia & explain why

Autoimmune diseases, chronic infections, chronic kidney disease (decreased production of erythropoietin ), & Inflammatory bowel disease (chronic blood loss and impaired iron absorption)

Which cells ingests foreign material & cellular debris, destroy infectious agents & cancer cells, are inflammation mediators, & produce antibodies?

Leukocytes

(Alterations in Leukocytes) Which term refers to a condition in which the white cell (leukocyte count) is above the normal range in the blood, which can be physiologically caused due to infection or inflammation; or pathologically due to malignancies? What are manifestations of said condition?

Leukocytosis - Fever, feeling weak, tired, or sick - Feeling dizzy, faint, or sweaty. - Pain or tingling in your arms, legs, or abdomen. - Trouble breathing, thinking, or seeing. - Losing weight without trying, or a poor appeti

(Alterations in Leukocytes) Which term refers to the condition where there are a decrease in the number of leukocytes, thus placing the individual at increased risk of infection? What are the manifestations of said condition?

Leukopenia - Similar to that of infection, including fever & chills. Also more prone to infections

Which term refers to a glandular fever, is an infection most commonly caused by the Epstein–Barr virus (EBV), where most people are infected by the virus are between the ages of 15-24, also the disease produces few or no symptoms? Its mainly transported through saliva, where the lymph nodes get enlarged and are palatable around the neck Which dangerous manifestation might people experience with this condition ? & what are the manifestations of said condition?

Infectious mononucleosis -Splenomegaly: Which is the rupture of the spleen due to enlargement, where contact sports need to be avoided until resolved - Headache, malaise, joint pain, fatigue, fever, sore throat, & lymph node enlargement

Which term refers to the overproduction of malignant leukocytes, where the overcrowding of bone marrow and decreased production and function of normal leukocytes causes pancytopenia? Describe the difference between acute & chronic leukemia Lymphocytic leukemia, (Acute and chronic) or ALL & CLL is...? Myeloid leukemia (Acute and chronic) or AML & CML is...?

Leukemia - Acute types happens in children or young people, with fast & dramatic manifestations. Chronic happens. Mostly in older people developing over years. They are detected during annual check ups with nonspecific signs & symptoms. - Too many lymphoblasts (immature lymphocytes) - Too many myeloblasts (immature granulocytes)

Acute leukemia

Which type of leukemia are there excessive build up of relatively mature, but still abnormal, WBCs, taking months or years to progress, forms of such can be monitored for extended time before treatment to increase effectiveness, & most common in older population?

Chronic leukemia

(Risk factors for leukemia) The rate leukemia is high in __ ___ countries, it’s a correlation nor a causation. Exposure to __ before birth Previous ___ ___ ___ including ___ ___ Exposure to ___ ___

- Higher developed - X-rays - Chemotherapy - Genetic conditions; Down syndrome - Ionizing radiation

(Acute Leukemia manifestations; AML & ALL) Which include... Due to the sudden onset, causing such factors Increased chance of bleeding, which can manifest in skin & bleeding gums, or bruises is related to? Fatigue is related to ? & what are the treatments?

- A sudden onset of increased WBCs not allowing bone marrow to produce enough RBCS and platelets, causing anemia and thrombocytopenia. - Also more prone to infections, anorexia, muscle wasting, & difficulty swallowing - Thrombocytopenia - Anemia - Chemotherapy & stem cell transplant

(Chronic Leukemia manifestation – CLL & CML) Which term refers to the slow growing disease with immature myeloblasts, In which 70% of cases are be asymptomatic? Which term refers to the slow growing disease with too many immature lymphocytes are made, that is most in western world with a longer life expectancy? Also, 70% of cases are asymptomatic as well.

- Chronic Myelogenous Leukemia - Chronic lymphocytic leukemia

(Chronic Leukemia – CLL & CML) 3 stages of chronic leukemia: Is the phase lasting 2-5 years and may be asymptomatic? Is the phase lasting 6-18 months where the primary symptoms develop, such as lymphadenopathy (swollen lymph nodes most common, which its tender & patient feels pain). This phase can also have decrease in neutrophils, which can cause infections Is the phase lasting 3-6 months with splenomegaly (painful, liver enlargement), diagnosed by lab analysis of blood and bone marrow

- Chronic phase - Accelerated phase - Terminal blast phase

(Hemorrhagic Disorders - Alterations of Platelets) Which term refers to the adequate number of platelets, normal levels of coagulation factors, and absence of defects in the vessel walls? What are the 3 factors that a platelet disorder can occur? & which term refers to the condition in which you have a low blood platelet count < 150 * 10^9, which can result in spontaneous bleeding that can be fatal if it occurs in lungs, GI tract, or CNS?

- Hemostasis - Platelet disorders (primary hemostasis defect), coagulation defects (secondary hemostasis defect), or, in some cases, a combination of both - Thrombocytopenia

(Hemorrhagic Disorders - Alterations of Platelets) Which term refers to the a rare and devastating immune mediated adverse drug (heparin) reaction, triggered by the immune system in response to heparin, which causes a low platelet count (thrombocytopenia) after 5 to 10 days of heparin therapy? Where sometimes there is 50% reduction in # of platlets Which type of heparin is this condition more likely to occur with & which is it not? Which lab value is monitored in these patients? 30% of patients develop prothrombic state: Which in the venous system can develop... & in the arterial system can develop

Heparin‐induced thrombocytopenia (HIT) - Unfractionated heparin (UFH), than low molecular weight heparin (LMWH - such as noxaparin & tinzaparin) - Measuring the activated partial thromboplastin time (aPTT), which measures the number of seconds it takes for a clot to form in a sample of blood after substances (reagents) are added. - Deep Vein Thrombosis & pulmonary embolism - limb ischemia, & could leads to stroke or myocardial infarction

(Hemorrhagic Disorders - Alterations of Platelets) Which term refers to the sudden reduction of the # of platelets due to an immune response, that is called idiopathic in some scenarios since there are no known causes at time? The acute version of this condition is most common in ___. & often follows or is secondary to ___ ___. & are resolved when the ___ is resolved. The chronic version of this condition is most common in ___. Which is the result of ____ against 1 or more platelet ___

Immune Thrombocytopenia Purpura or idiopathic thrombocytopenic purpura - Children; viral infections; infection - Autoantibodies; glycoproteins

(Hemorrhagic Disorders - Disorder of Coagulation) The reduction of levels of which vitamin can create bleeding disorders? Impaired hemostasis can happen due, to diminished levels of __ __ (__), excessive ___ (__)/ __ __, & liver disorder or lack of vitamin __ Which term refers to typically an inherited bleeding disorder in which the blood does not clot properly?

- Vitamin K deficiency - Coagulation factors (hemophilia); clotting (thromboembolic)/pulmonary embolism; K - Hemophilia

Which system links the immune & hematological systems, is the site where various WBC’s can mature and function, maintains volume balance between blood & the interstitial fluids, & initiates adaptive immune responses? What are the primary structures of said system called? & What are the secondary structures of said system called?

- Lymphatic system - Bone marrow & thymus gland - Spleen, lymph nodes, tonsils, Peyer’s patches (small intestine), & appendix

Which term refers to the disease of the lymph nodes, in which they are abnormal in size or consistency? The localized version of this condition is associated with...? The Generalized version of this condition is associated with...? & what are the 4 causes of this disease?

Lymphadenopathy or adenopathy - Associated with an inflammatory process or infection - Associated with a malignant or nonmalignant disease - Neoplastic disease, immunological or inflammatory conditions, endocrine disorders, or lipid storage disease

Which term refers to where cancer that begins in the lymph nodes as a result of genetic mutation or infection? Broken into 2 classifications: Hodgkin & nonHodgkin lymphoma – and then broken into slow-growing or fast-growing List & describe the 4 stages of said condition

- Lymphoma Stage 1 – single lymph node involvement Stage 2 – 2 or more lymph nodes on same side of the diaphragm Stage 3 – lymph nodes on both sides of the diaphragm Stage 4 – involvement of extralymphatic organs – spleen, thymus gland, tonsils, ileum, appendix

(Lymphoma) Which term refers to a type of lymphoma in which cancer moves from one lymph node to another, where symptoms include fever, night sweats, & weight loss? Often there will be non-painful enlarged lymph nodes in the neck, under the arm, or in the groin. It is also considered one of the most treatable forms of cancer if found early. & how is diagnosed?

- Hodgkin lymphoma (HL) - Blood work & lymph nose biopsy

(Lymphoma) Which term refers to not a single disease but a group of disease, where tumors develop from lymphocytes, and its more common than its counterpart, mostly affecting B cells (85%) than T cells? Also, the overall 5-year relative survival rate for people with NHL is 72%. What are some risk factors of said disease?

Non-Hodgkin's lymphoma - Older adults, male, white + having one of the following: -Inherited immune disorders -Autoimmune disease (HIV/AIDS) - Exposure to chemicals/pesticides

*Edit* (Lymphoma) What is the difference in manifestations of non-Hodgkin’s and Hodgkin’s? Also what are some manifestations of non-Hodgkin’s lymphoma?

- Symptoms of Hodgkin’s lymphoma are not immediately obvious & may be mistaken for a severe cold or flu. - Localized or generalized lymphadenopathy – usually cervical, axillary, inguinal and femoral lymph nodes - Multiple peripheral node involvement with non-tender nodes - Depending on node involvement could also have backpain, ascites, itching & skin rash, profuse night sweats

(Lymphoma) Where Hodgkin lymphoma most often localized to a single group of nodes (e.g. cervical), whereas Non-Hodgkin lymphoma.... Where Hodgkin lymphoma orderly spreads, whereas Non-Hodgkin lymphoma.... Where Hodgkin lymphoma rarely involves mesenteric nodes & Waldeyer ring, whereas Non-Hodgkin lymphoma.... Where Hodgkin lymphoma extranodal involvement is uncommon, whereas Non-Hodgkin lymphoma....

- Most often involved multiple peripheral nodes - Non-contiguously spreads - Commonly involves mesenteric nodes & Waldeyer ring - Extranodal involvement is common