Hematology Flashcards
What pathology is associated with this pathologic RBC disease: Lead poisoning
Basophilic Stippling
What pathology is associated with this pathologic RBC disease: G6PD Deficiency
Degmacyte (“bite cell”)
What pathology is associated with this pathologic RBC disease: Hereditary elliptocytosis
Elliptocyte
What pathology is associated with this pathologic RBC disease: Megaloblastic anemia (hypersegmented PMNs), marrow failure.
Macro-ovalocyte
What pathology is associated with this pathologic RBC disease: Sideroblastic anemia. Excess iron in mitochondria=pathologic
Ringed sideroblast
What cell type/shape is associated with this pathologic RBC disease: Microangiopathic hemolytic anemias, DIC, TTP/HUS, HELLP syndrome, mechanical hemolysis (e.g. heart valve prosthesis). —> fragmented RBCs
Schistocyte (“helmut cell”)
What pathology is associated with this pathologic RBC disease: Sickling of cells can occur during times of dehydration, deoxygenation, and at high altitude.
Sickle cell
What cell type and pathology is associated with this pathologic RBC disease: small spherical cells without central pallor, drug-and infection-induced hemolytic anemia.
Spherocytes + Hereditary Spherocytosis
What pathology is associated with this pathologic RBC disease: Bone marrow infiltration (e.g., myelofibrosis). RBC “sheds a tear” because it’s mechanically squeezed out of its home in the bone marrow.
Dacrocyte (“teardrop cell”)
What pathology is associated with this pathologic RBC disease: HbC disease, Asplenia, Liver disease, Thalassemia.
Target cell (RBC looks like Target sign).
What cell type is associated with this pathologic RBC disease: Seen in G6PD deficiency; ______ inclusions seen in alpha-thalassemia. –> Oxidation of Hb-SH groups to S-S- –> Hb Precipitation, with subsequent phagocytic damage to RBC membrane –> ____ cells caused by spleen.
Heinz Bodies and
Bite cells
What pathology is associated with this pathologic RBC disease: Basophilic nuclear remnants found in RBCs. Seen in Px with functional hyposplenia or Asplenia.
Howell-Jolly bodies - They are normally removed from RBCs by splenic macrophages.
Coagulation Disorders: What is the function of a PT test? Which coagulation factors does it involve?
Involves factors I, II, V, VII, and X.
–> A defect would increase PT (because clotting cannot occur).
Coagulation disorders: PTT is a function to test what? What clotting factors does it involve?
PTT tests function of common and intrinsic pathway (all factors except VII and XIII). A defect would lead to increased PTT (blood is unable to clot).
Hereditary syndromes leading to hypercoagulability: Inherited deficiency of antithrombin: has o direct effect on the PT, PTT, or thrombin time but diminishes the increase in PTT following heparin administration. Can also be acquired: renal failure/nephrotic syndrome –> antithrombin loss in urine –> decrease inhibition of factors IIa and Xa.
Antithrombin deficiency
These cells are distinctive tumor giant cells seen in Hodgkin disease; binucleate or bilobed with the 2 halves as mirror images (owl eyes). RS cells are CD15+ and CD30+ B-cell origin. Lymphocyte-rich form has best prognosis. Lymphocyte mixed or depleted forms have worse prognosis.
Reed-Sternberg cell
What pathology is associated with this pathologic RBC disease: Liver disease, abetalipoproteinemia (states of cholesterol dysregulation).
Acanthocyte (“spur cell”)
Associated Translocations: 8;14
Burkitt Lymphoma
Associated Translocations: t(15;17)
M3 type of AML
Treatment is with all Trans-Retinoic Acid
Associated Translocations: t(8;21)
AML
What condition is associated with a defect in the following enzyme: Uroporphyrinogen decatboxylase
Porphyria cutanea tarda–> looks like homeless man!
Blisters with photosensitivity, etc.
What condition is associated with a defect in the following enzyme: porphobilinogen deaminase aka: uroporphyrinogen-1-synthase
Acute intermittent porphyria
5Ps: painful abdomen Port-wine colored urine Polyneuropathy Psychological disturbances Precipitated by drugs: cytochrome P-450 inducers, alcohol, rifampin, metoclopramide, and starvation.
What is the most common type of Non-Hodgkin Lymphoma in adults and the US? What is the associated translocation?
Diffuse Large B Cell Lymphoma
t(14;18)
What is the associated translocation in Mantle Cell Lymphoma? What portion of the population is it more associated with?
T(11;14) - older males CD5+
What type of neoplasm is associated with long term celiac disease?
Adult T-Cell Lymphoma caused by HTLV (IV drug abuse) –> lyric bone lesions, hypercalcemia
What disease is at hand: adenosine deaminase deficiency?
SCID - severe combined immunodeficiency disorder
What disease is at hand: Neutrophils fail to respond to chemotactic stimuli?
Could be either:
Job Syndrome (hyper IgE syndrome)
OR
Leukocyte adhesion deficiency syndrome
What is a Kupffer cell?
It is a Macrophage that is found in the liver.
What is a histiocyte?
It is a Macrophage that is found in Connective Tissue.
What is a Langerhans cell?
It is a Macrophage that is found in the Skin!
What is a microglial cell?
It is a Macrophage that is found in the Brain
What is an osteoclast and what does it do?
Basically a macrophage that is found in bone! It also absorbs bone tissue during growth and healing.
What are some causes of Eosinophilia (PACCMAN)?
Parasites Asthma Churg-Strauss Syndrome Chronic adrenal insufficiency Myeloproliferative disorders Allergic Process Neoplasia (eg Hodgkin Lymphoma)
What is the MOA of Warfarin?
Inhibits epoxide reductase —> responsible for recycling Vitamin K
Vit K is needed for creating Vit k dependent clotting factors.
What drug is used to reverse the effects of Heparin?
Protamine sulfate
What is the rescue drug for Warfarin overdose?
Vitamin K or Fresh frozen plasma
What are the three most common Thrombolytic drugs? What is the MOA of these drugs?
Streptokinase
Urokinase
tPA (alteplase)
RESCUE: Aminocaproic Acid
They activate plasmin —> plasmin degrades fibrin (clot)
C/I in Px with active bleeding, Hx of intracranial bleeding, severe hypertension, recent surgery, or an unknown bleeding disorder.
What are the 3 main functions of Bradykinin?
- Vasodilator
- Increases vascular permeability
- Mediator of pain
What kind of RBCs are seen in asplenic patients??
- Howell-Jolly bodies
- Target Cells
What is the rate limiting enzyme for heme synthesis?
Aminolevulinic acid synthase
Made from Glycine and succinyl-CoA —> and make aminolevulinic acid with the help of Vit. B6
48 y/o male presents with blistering of the skin from photosensitivity, tea colored urine, hypertrichosis, facial pigmentation, has HEP C, elevated LFTs, and is an alcoholic. What is the most likely diagnosis?
Porphyria cutánea tarda
What is the pathology at hand: Dysplasia of the hematopoietic cells in the myeloid tissue and disordered hematopoiesis. On peripheral blood smear, neutrophils have nuclei with 2 loves that are connected by a thin strand (like poncinot glasses worn by Rosevelt). What is this finding called as well.
Myelodysplastic Syndrome
(Pre-leukemia) and the blood smear shows “Pelger-Huet Anomaly”
