hematology Flashcards
CLL
most common
smudge cells
hallmark- isolated lymphocytosis, w/ a leukocytosis >20,000
CML
philidelphia chromosome (BCR-ABL)
hallmark- leukocytosis w/ median wbc of 150,000
tx- imatinib mesylate (gleevec)
AML
auer rods
ALL
most common in kids
multiple myeloma
rouleaux formation (rbc stack like coins)
bence jones proteins
malignancy of plasma cells prod abundance monoclonal paraprotein ( m protein)
pancytopenia
hypercalcemia
light chain components can lead to renal failure
sickle cell anemia
howell jolly bodies
G6PD
heinz bodies
lead poisoning
basophillic stippling
microcytic anemia
prussian blue staining of bone marrow shows sideroblasts
tx- chelation tharpy
Schistocyte (helmet)
TTP
DIC
heart valce
target cells
thalassemia
bite cells
g6pd
anisocytosis
cells w/ different size
iron deficiency
microcytic anemia
TICS thalasemia iron deficiency chronic disease sideroblastic (lead poisoning)
normocytic
hemolysis renal failure hypothyroid liver disease chronic disease cancer
macrocytic
b12
folate
hemolysis
alpha thalasemia
defect in alpha production
more common in chinese
beta thalasemia
defect in beta chain prod
more common in mediteranian and african
thalasemia vs iron deficiency vs chronic disease
iron- low iron, high tibc, low ferritin
chronic disease- low iron, low tibc, high feritin
thalasemia= normal/high iron, normal tibc, normal ferritin, elevated LDH (more microcytic then others (60))
iron deficiency
most common cause of anemia
pica, dysphagia, brittle nails, cheilosis, smooth tongue
plumer vinson syndrome
tx ferrous sulvae 325 mg tid
anemia of chronic disease
70% normocytic 30% microcytic
increse hepcidin levels which decrease iron absorbion from GI and decrease iron release from bone marrow
folic acid antagonist
bactrim, methotrexate, phenytoin
folic acid anemia
common in alcoholics
diets low in fruit and vegetables
can get howell jolly bodies (also in sickle cell)
ELEVATED HOMOCYSTEINE LEVLS with NORMAL METHYLMALONIC ACID (MMA) (how to differentiate from b12)
tx- folic acid 1mg/day
B12 deficiency
pernicious anemia is most common cause (lack of intrinsic factor)
lack of meats
gastric surgery
pancreatic insufficiency
metformin use
crohns disease
neuroliogic findings- stocking glove paresthesias, losss of position, fine tough, and vibration, balance problems/ataxia
Hypersegmented neutrophils
Schilling test
BOTH MMA AND HOMOCYSTINE LEVLS ARE INCREASED
tx- b12 1000 monthly IM
coombs test
test to see if autoimmune destruction of rbc
(direct coombs on rbc)
(indirect coombs in serum)
