Hematology Flashcards
Metalloprotease ADAMSTS13
Cleaves Willebrand factor
PLASMIC SCORE
Scoring system that aids in diagnosing iTTP
Thrombotic anti phospholipid syndrome
Eculizumab and ravulizumab
Antiphospholipid
Lupus anticoagulant, anticardiolipin, anti-beta-2-glycoprotein antibodies
Complement activation
- Classical (Aby-atgn complex)
2.Lectin pathway activ. Mannose binding lectin - Alternative pathway
Main players of complement
C3, C5a (potent pro inflammatory),C5b-9 ( membrane attack complex)
Complement mediated disorders
Paroxysmal nocturnal hemoglobinuria, cold agglutinin, aHUS,
Anaphylatoxins C3a, C5a, C5b-9
C3a, C5a, C5b-9
C3a and C5a release
Pro inflammatory & procoagulant cytokines such: tumor necrosis factor,
Interleukin-6 from monocytes & endothelial cells
Monocytes & endothelial cells induce
TNF & interleukin -6 which induce tissue factor
C5a recruits
Neutrophils which induces neutrophil tissue factor dependent procoagulant.
C5a-9 induces secretion via endothelial and platelets
VWF, p selectin, pro- inflammatory cytokines, procoagulant extracellular vesicles
Monocytes release
TNF & Interleukin 6
Neutrophil release
Tissue factor dependent procoagulant activity
Neutrophils, monocytes, platelets
Hypercoagulable
C3 activates platelets and fibrin formation
Complementopathies cause thrombosis often refractory to anticoagulation and seen triggered in:
Pregnancy, inflammation, cancer, PNH, cold agglitinin, aHUS, transplant microangiopathy, HELLP, APS, CAPS
Complement inhibitors
Eculizumab, ravlizumab
Complement inhibition
CAPS, HELLP
Waldenström macroglobulinemia
- Indolent B cell lymphoma
- Hepatosplenomegaly
- Lymphadenopathy
- Circulating IgM
ITP
Anti-CD 38 monoclonal antibody
CM313
Iron deficiency (hepcidin controls release of iron)
- Ferritin <100
OR - Ferritin 100-300 and total iron saturation <20%
HELLP syndrome
Hemolysis
Elevated LFT
LOW PLATELETS
Autoimmune cytopenia
Cryoglobulinemia
Diagnostic testing; cbc with diff, SPEP, serum protein immunofixation,CT scan (thoracic, abdomen), PET scan, bone marrow biopsy.
Type II,III VIRAL PANEL B,C
ANA, anti double dna, salivary gland biopsy
Flow cytometry
Helps distinguish malignancy