Hematology Flashcards
What is Chronic Myelogeneous Lukemia (CML)?
Who gets it?
Signs?
Bone Marrow Bx Finding that is diagnostic?
Causes leukocytosis (leukocytes are all the WBCs including lymphocytes(B and T cells), monocytes, neutrophils. WBC>150,000.
Affects the young to middle aged adults.
Splenomegaly, anemia, thrombocytosis.
Philadelphia chromosome in the bone marrow is diagnostic.
What type of lymphocyte is affected in Chronic Lymphocytic Leukemia? What is seen in the CBC? What is the typical presentation? What is seen on the blood smear? Staging System?
Clonal malignancy of B cells. MC leukemia found in adults.
Increased mature lymphocytes; WBC >20,000.
Adult having recurrent infections.
Smudge cells.
Rai System
Acute Lymphocytic Leukemia:
Who does this affect?
Labs?
S/s?
Children; good cure rate.
Pancytopenia with circulating blasts (lymphoblasts have unrestrained growth; take over bone marrow, so decreases everything else.)
Anemia, increased infection/fever due to neutropenia, gingival bleeding/epistaxis
Acute Myelogeneous Leukemia: Who does this affect? What does this cause? Lab findings? What is found on bone marrow BX?
Adults; 60-70% cure rate.
Myeloblasts crowd out the bone marrow and decrease cells fighting infection (myeloblasts become neutrophils, basophils, eosinophils).
Pancytopenia with circulating blasts;
Auer rods.
Idiopathic Thrombocytopenia Purpura (ITP):
What does this cause?
What are the characteristics in childhood onset? Tx?
Characteristics in adulthood? Tx?
T cell mediated destruction: spleen gets rid of PLTs; antibody mediated PLT destruction.
Childhood: acute, self limiting, usu 2-3 weeks post immunization or infx.
Adults: more serious, insidious turning chronic, no preceding illness, needs tx(steroids, IVIG, Splenectomy).
Thrombotic Thrombocytopenia Purpura (TTP):
What does this cause?
S/S?
Tx?
More serious and rare. Cause blood clots to form in small blood vessels throughout body resulting in decreased PLTs.
CNS sxs, thrombocytopenia, anemia, acute renal failure (rare.)
Note: giving PLTS will kill the patient. Fresh frozen plasma, IVIG, splenectomy.
Hemolytic Uremic Syndrome (HUS): Who does this affect? Triad? Typical cause? Classic sxs? Dx? Seen in blood smear? Tx?
Childhood: 6mo to 4 yrs
Triad: Hemolytic anemia, thrombocytopenia, acute renal failure.
Caused by E. Coli.
Initially non bloody D, then painful bloody D, then Plt-Fibrin Clots.
DX: stool for Shiga toxin, urine.
Labs show schistocytes(remnants of destroyed RBCs).
Supportive, IV fluids; abxs can increase toxic levels.
What is Disseminated Intravascular Coagulation (DIC)?
What causes this?
Dx?
Tx?
Widespread microvascular thrombosis.
Result of sepsis, malignancy, trauma, hepatic failure, pancreatitis, TX rejection.
Dx with increased D-Dimer
Tx underlying cause, PLTS if <10-20 K
What is Heparin Induced Thrombocytopenia (HIT)?
Clin presentation?
Dx?
Tx?
Antibodies activate PLTs causing plugs (thrombus) in arteries and veins. Plts get all bound up and become plugs in blood vessels.
Venous and arterial thrombosis, skin lesions.
Dx: thrombocytopenia (<150k or >50% drop from baseline), about 5-14 days after giving heparin.
Stop heparin, no PLTS, no Coumadin until PLTs are normal
What do you see on exam with Lymphoma(Hodgkin’s and non-Hodgkin’s)?
Which type of lymphoma has the Reed-Sternberg Cell?
Which type of lymphoma is more responsive to chemo?
Painless lymphadenopathy: cervical, supraclavicular, +/- mediastinal.
Hodgkin’s lymphoma.
Hodgkin’s lymphoma.
What is Multiple Myeloma? Special Lab finding? What is seen on the peripheral smear? What is seen on radiograph? Clinical findings? Tx?
Malignancy of plasma cells (plasma cells produce antibodies known as immunoglobulins): It is a hyper viscosity syndrome. Abnormal antibodies produced with myeloma are called paraproteins.
Bence-Jones protein.
Rouleaux formation (stacked RBCs)
Lytic lesions.
Anemia, bone pain: get bone destruction fxs in low back or ribs; infection; others: renal failure, hypercalcemia;
Tx: chemo and TX options, bisphosphanates for adjunct.
thalidomide, dexamethasone.
What is the clinical presentation with Hemophilia A and B?
A has what factor deficiency? B?
Lab?
Clinically indistinguishable: both have pain, hemarthoses.
A is factor VIII deficiency, B is factor IX deficiency (Christmas Dz)
Increased PTT.
What is the disease that is a neoplastic marrow disorder that has uncontrolled RBC production causing increased absolute RBC mass?
Lab finding?
Tx?
Polycythemia Vera.
Increased HCT(% RBCs in the total volume of blood)
Phlebotomy.
What type of thrombophilia can be assoced with Systemic Lupus Erythematous?
Antiphospholipid antibody syndrome.
What is the MC form of hemophilia?
Type A: Factor 8 deficiency
