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Clues > Hematology > Flashcards

Hematology Flashcards

1
Q

High WBC and PMNs, what does this mean?

A

Stress demmargination
This happens after surgery, trauma

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2
Q

High WBC and less than 5% blasts

A

Leukemia reaction
Burn patients, extreme stress. Looks like leukemia

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3
Q

High WBC and Bands

A

Left Shift (infection)

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4
Q

High WBC and more than 5% blasts

A

Leukemia

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5
Q

High WBC and B cells

A

Bacterial infection

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6
Q

Causes of eosinophilia

A

Allergy, neoplasm (lymphoma), Addison’s (relative), collagen vascular disease, parasites

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7
Q

Causes of high monocytes

A

Syphilis, Tb, EBV, Listeria, Salmonella

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8
Q

High reticulocyte count

A

Peripheral RBC destruction

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9
Q

Poikilocytosis

A

RBCs of different shape

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10
Q

Anisocytosis

A

RBCs with different sizes

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11
Q

Microcytic hypo chromic anemias

A

Fe deficiency
Lead Poisoning, sideroblastic anemia
Thalassemias
Anemia of chronic disease

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12
Q

Labs of iron deficiency anemia

A

Increased TIBC
Koilonychia

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13
Q

Labs of anemia of chronic disease

A

Decreased TIBC

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14
Q

Labs of sideroblastic anemia

A

Decreased dALA synthase
Common in blood transfusions

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15
Q

Alpha thalassemia

A

Chr 16 deletion
Asian and Black people

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16
Q

Beta Thalassemia

A

Chr 11 point mutation
Mediterraneans

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17
Q

Folate vs B12 deficiency

A

Folate has glossitis

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18
Q

FAS

A

Smooth philtrum, short, polyclonal, mid face hypoplasia
Thin superior vermilion border

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19
Q

Intravascular hemolytic anemias

A

G6PD deficiency
IgM cold agglutinins
Auto-immune

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20
Q

Extra-vascular hemolytic anemias

A

Spherocytosis
Warm autoimmune
Paroxysmal nocturnal hemoglobinuria
Sickle Cell

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21
Q

X Ray findings of Sickle cell

A

Crew-cut, Avascular necrosis of the femur

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22
Q

Diamond Blackfan Anemia

A

Low RBCs
Double jointed thumbs

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23
Q

Bite Cell

A

Unstable Hb inclusions
G6PD deficiency

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24
Q

Burr Cell

A

Echinocyte
PK deficiency
Liver disease, post-splenectomy

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25
Q

Cabot’s Ring Body

A

B12 deficiency and lead poisoning

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26
Q

Dohle body

A

PMN Leukocytosis
Infections, steroids, tumor

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27
Q

Drepanocyte

A

Sickle Cell

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28
Q

Heniz Body

A

Hb precipitates and sticks to cell membranes in G6PD deficiency

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29
Q

Howell Jolly Body

A

Spleen or marrow should have removed it, wasn’t able to
Hemolytic anemia, spleen trauma, CA

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30
Q

Pappenheimer Body

A

Iron inside cell. Sideroblastic anemia

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31
Q

Rouleaux formation

A

MM, spherocytosis

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32
Q

Target Cell

A

Codocyte
Less Hb
Thalassemias or Iron deficiency

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33
Q

Tear drop cell

A

Dacrocyte
RBCs squeezed out of marrow
Hemolytic anemia, marrow CA

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34
Q

Etiology of joint, cavity bleeds

A

Clotting factor problem
Platelet problems bleed from skin and mucosa

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35
Q

Factor 13 deficiency

A

Umbilical stump bleeding (first time a baby has to stabilize a clot)

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36
Q

Pruritis after bathing

A

Polycythemia vera

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37
Q

Histiocytosis X

A

Histiocyte proliferation
Kid with Eczema, skull lesions
Hand-Schuller-Christian Dz

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38
Q

Direct Coombs test

A

Ab on surface
Seen in hemolytic andemias

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39
Q

Indirect Coombs test

A

Ab freely circulating in serum

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40
Q

When do you give RhoGam

A

1st dose at 28 weeks
2nd dose 3 days before delivery

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41
Q

Cytokine released upon MO activation

A

IL-1

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42
Q

Cytokines stimulated by T helpers

A

All IL except IL-1

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43
Q

CD8

A

T Killer or T suppressor cell
Responds to MHC-1 complex (self)

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44
Q

Cells expressing MHC-1

A

All nucleated except immune-privileged cells

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45
Q

MHC-2 cells

A

APCs (MO, dendrite, neutrophils)

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46
Q

CD-4 Cells

A

T-helper, responds to MHC-2 (foreign)

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47
Q

TH2 immunity type

A

Humoral enhancement

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48
Q

CVID

A

Young adults, B cells don’t WORK

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49
Q

Brutons A Gammaglobulinemia

A

Kids with defective TK
No Abs
X Recessive

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50
Q

Job Syndrome

A

Red headed females
Stuck in IgE phase

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51
Q

MM

A

IgG and Kappa light chains increased
Rouleaux formation

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52
Q

easy chain disease

A

IgA and MM of GI tract

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53
Q

IgG2 deficiency

A

Recurrent encapsulated infections

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54
Q

Selective IgA deficiency

A

Seen in transfusion, anaphylaxis, mucous membrane infections

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55
Q

Hairy cell leukemia

A

Fried egg / sunburst cells
TRAP+
BRAF
Dry Tap

56
Q

Ataxia telangiectasia

A

Low IgA
Neuro problems
Spider-like blood vessels

57
Q

T cell deficiency patient death

A

Viral, fungal infections. NOT BACTERIAL

58
Q

SCID

A

No thymus (no T cells)
Frayed long bones (no B cells)
Baby dies by 18 mo

59
Q

Wiskott Aldrich

A

Low IgM, platelets,
High IgA
Eczema, petechiae
X-Linked

60
Q

HIV tests

A

ELISA: IgG Ab to p24 Ag
Western Blot
PCR (babies)

61
Q

CGD

A

NADPH Oxidase deficiency
Recurrent Staph/Aspergillus (Nitro-blue -)
MPO deficiency

62
Q

MPO deficiency

A

Causes catalase positive infections

63
Q

Myeloid vs Lymphoid Leukemias

A

Myeloid: Increased RBC, Platelets, MO. Marrow Bx
Lymphoid: T/B/NK cells. LN Bx.

64
Q

ALL

A

0-15 y.o.
Bone pain
PAS+ TdT+ CALLA Ag, CD10+
T12;21

65
Q

AML

A

15-30 yo
Sudan Stain
Auer Rods
CD30 15;17

66
Q

CML

A

30-50 yo female
9;22 Philadelphia BCR-ABL

67
Q

CLL

A

50yo+ males
Soccer ball nuclei
Hemolytic anemia
Lymphadenophathy
CD20, 23, 5+

68
Q

B cell NHLs

A

Follicular: 14;18 and bel-2
Burkitt: 8;14 and c-myc

69
Q

T cell NHLs

A

Mycosis Fungoides: total body rash
Sezary syndrome: cerebreform cells in the blood

70
Q

Myelofibrosis

A

Teardrop RBCs
Dry tap, extra medullary fibrosis

71
Q

Waldenstrom macroglobulinemia

A

IgM and hyperviscosity

72
Q

MGUS

A

Old person with Gamma spike

73
Q

Heavy chain disease

A

Increased IgA

74
Q

Microcytic anemia

A

Defective Hb synthesis
Fe deficiency, Thallasemias, Lead poisoning
Anemia of chronic disease

75
Q

Treat lead poisoning

A

Ferrochelatase
D-ALA dehydrates

76
Q

Eosin-5-mealimide

A

tests for hereditary spherocytosis

77
Q

Macrocytic anemias

A

B12, B1, B9
Homocysteinurea
Orotic acidemia
Diamond blackfan
Fanconi

78
Q

Sickle Cell pathology

A

Glutamate substituted for Valine

79
Q

Tx for vaso-occlusive crisis

A

Fluids: NS and HCO3-
Morphine
O2

80
Q

TTP

A

Purpura, Fever, RF, Neuro changes, Hemolytic anemia
Schistocytes on smear
ADAMTS13
Tx w/ plasmapheresis

81
Q

Treat vWB

A

Mild: DDAVP (vasopressin)
Moderate: increased HR: cryoprecipitate (F8, F5. vWF, fibrinogen)
Severe: give cryoprecipitate until hb is 7

82
Q

ALL

A

Kids 0-5
Tx w/ Rituximab, prednisone
CALLA Ag is best version
AML

83
Q

AML

A

Everyone ages 0-89
Tx w/ Azacitabine, Decitabine, Cytarabine

84
Q

APL

A

PML-RAR from 15;17
DIC, thrombocytopenia
Auer rods
Tx w/ ATRA (induces cell maturation)

85
Q

CML

A

45-56 yo
Philadelphia 9,22
Blast crisis
Treat with Imatinib / TK inhibitor (Gleevek)

86
Q

CLL

A

Old people, 56+
Smudge cells on histology
Anemia, lymphadenopathy, splenomegaly
Decreased neutrophils, eosinophils, basophils
Tx w/ nothing, prednisone, rituximab

87
Q

Hodgkin Lymphoma

A

20 - 40 yo
Reed-sternberg cells (CD30)
Begins as swollen LN
Nodular sclerosis, lymphocyte depleted, predominant, mixed lymphocytic

88
Q

Burkitt Lymphoma

A

BCL-2, C-myc
8;14
EBV
Starry sky (swirling macrophages)

89
Q

Staging of Lymphoma

A
  1. 1 group of LN. Radiate.
  2. 2+ LN, Same Side of diaphragm. Radiate.
  3. 2+ LN, both sides. Chemo
  4. Mets. Chemo, then radiation
90
Q

Treat Lymphoma

A

Adriamycin (dilated cardiomyopathy)
Bleomycin (pulmonary fibrosis)
Vincristine (Peripheral neuropathy)
Dacarbazine (hepatoxic)

91
Q

Polycythemia Vera

A

Itching after shower from basophils, mast cells
Splenomegaly, gout, LAP
Tx w/ phebotomy, 0.9NS, Aspirin, Anegrolide

92
Q

Tear drop cells

A

Dacrocytes from Myelofibrosis
Islands of stem cells, dry tap (along with hairy cell)

93
Q

Hairy Cell

A

“Fried Egg”
B cell, TRAP+, Dry Tap
Tx w/ Clodribine

94
Q

Pure T cell lymphomas

A

Mycosis Fungoides (into blood is Sezary)
B Sx

95
Q

Papillary thyroid cancer

A

Local mets only, from RADIATION treatment
Psammoma bodies

96
Q

Hot Thyroid Nodule

A

Treat hyperthyroidism (propranolol)

97
Q

Cold Thyroid Nodule

A

Hx of Irradiation to the neck? Lobectomy
No Irradiation to the neck? Lobectomy only if malignant

98
Q

Diastolic Plop

A

Myxoma
Usually left atrium
Middle aged female passes out, recovers seconds later
Connected to Estrogen

99
Q

Epiphysis Neoplasms

A

Chondroma (bump)
Chondrosarcoma (fried egg)
Epiphyseal stippling (from teratogenic warfarin)

100
Q

Metaphysis Neoplasms

A

Osteosarcoma: Codman’s Triangle / Starburst, Rb mut

101
Q

Diaphysis Neoplasms

A

Multiple Myeloma (punched out lesions)
Osteoid Osteoma (bump)
Pagets (Mosaic)
Ewing’s (layering / onion,11;22)

102
Q

CEA

A

GI Cancer Ag

103
Q

S100

A

Neural Crest, melanoma Cancer Ag

104
Q

AFP

A

Yolk sac, Hepatocellular Carcinoma Cancer Ag

105
Q

hCG

A

Choriocarcinoma Cancer Ag

106
Q

L-Myc

A

Small cell lung cancer ag

107
Q

N-Myc

A

neuroblastoma cancer ag

108
Q

Desmin

A

Connective tissue cancer ag

109
Q

Vimentin

A

Rhabdomyosarcoma ag

110
Q

Ca-125

A

Ovarian cancer ag

111
Q

CA-19

A

pancreatic ca ag

112
Q

BCL-2

A

NHL (<Follicular) cancer ag

113
Q

RET

A

Men2a/b, isolated thyroid cancer ag

114
Q

Rb

A

Retinoblastoma and osteosarcoma cancer ag

115
Q

9;22

A

CML

116
Q

8;14

A

Burkitt’s lymphoma

117
Q

14;18

A

Follicular lymphoma

118
Q

11;22

A

Ewing’s sarcoma

119
Q

15;17

A

APL

120
Q

Hereditary breast cancer markers

A

ERB
HER2nu
BRCA

121
Q

BRCA

A

Ovarian, pancreatic, gastric, hereditary breast cancer marker

122
Q

p53

A

Li Fraumeni (many primary cancers)

123
Q

BRAF

A

Hairy cell leukemia (V600E)

124
Q

JAK-2

A

Polycythemia vera
Essential thrombocytosis
Primary myelofibrosis

125
Q

cANCA

A

Granulomatosis w/ Polyangiitis

126
Q

pANCA

A

UC
Polyarteritis Nodosa
PSC
Churg-Strauss

127
Q

Diffuse Large B cell Lymphoma

A

Tx w/ Cyclophosphamide

128
Q

Track progression of CLL

A

RAI and Binet Staging system

129
Q

Hemophilias

A

A: F8 X-rec
B: F9 AD
C: F11 AR

130
Q

Treat iron overload

A

Deferoxamine

131
Q

Treat Wilson’s disease

A

Chelate with Penacillamine

132
Q

Sideroblastic anemia

A

Lead but also cyanide and Pyridoxine (B^) deficiency (AR)

133
Q

CLL histology

A

Scant cytoplasm
Mature clumped chromatin
No discernable nuclei

134
Q

Plasma cells with fried egg appearance

A

MM

135
Q

Histology of Nodular Sclerosing Hodgkin Lymphoma

A

Lacunar cells with collagen banding or fibrotic nodules

136
Q

Reed Sternberg cells

A

Associated with Hodgkin Lymphoma
Giant cells with bi-lobed nuclei and eosinophilic nucleoli

Clues (14 decks)

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