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Clinical Medicine 2 > Hematology > Flashcards

Hematology Flashcards

1
Q

What proteins are found in plasma?

A

Albumin, clotting factors antibodies

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2
Q

What is serum composied of?

A

Proteins, electrolytes, water

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3
Q

Where is blood made initially?

A

in liver

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4
Q

After what week does bone marrow begin to make blood?

A

15th week

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5
Q

What bones in the adult body make blood?

A
  1. Upper Femur/Humerus
  2. Vertebrae
  3. Ribs
  4. Sternum
  5. Clavicles
  6. Scapulae
  7. Skull
  8. Pelvis
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6
Q

All blood cell components stem from what type of cell?

A

Hematopoietic Stem Cell

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7
Q

What cells arise from myeloid progenitor cells?

A
  1. Neutrophil
  2. Basophil
  3. Eosinophil
  4. Macrophages
  5. Monocytes
  6. RBCs
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8
Q

What cells arise from lymphoid progenitor cells?

A
  1. NK cells
  2. B lymphocytes
  3. T Lymphocytes
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9
Q

What is the structure of a RBC?

A
  1. Bi-concave
  2. Flexible
  3. Not nucleated
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10
Q

What determines one’s blood group?

A

Based on the glycoprotein markes on surface of RBC

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11
Q

What’s the universal recipient blood group?

A

Group AB

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12
Q

What’s the universal donor blood group?

A

Group O - contains no antigens so antibodies can’t be formed against it

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13
Q

What is stimulated to make RBCs?

A

Erythropoietin

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14
Q

What organ produces EPO?

A

Kidney

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15
Q

What 5 things do you need to make healthy RBCs?

A
  1. Correct genes
  2. Iron
  3. B12
  4. Folate
  5. Normal functioning marrow
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16
Q

What is the hemoglobin amount for men and women w/ anemia?

A

Men < 13.5

Women < 12.0

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17
Q

When ordering a CBC,, mean corpuscular volume (MVC) is an important finding. What does it tell you?

A

Tells if microcytic or macrocytic anemia

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18
Q

What does the reticulocyte count tell you?

A

tells how many immature RBCs are in system

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19
Q

What’s the most common SE of anemia? Ocular SE? Nail Change?

A
  • Cardiorespiratory
  • Pallor of Palpebral Conj
  • Koilonychia (spooling of nails)
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20
Q

Microcytic anemia has what MCV? What diseases are associated with it?

A

< 80

  • Iron deficiency
  • Thalassemias
  • Sideroblastic Anemia
  • Lead poisoning
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21
Q

Normocytic anemia has what MCV? What diseases are associated with it?

A

80-100

  • Aplastic anemia
  • Sickle Cell
  • Bond marrow infiltration
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22
Q

Macrocytic Anemia has what MCV? What diseases are associated with it?

A

> 100

  • Megaloblastic anemias
  • Liver disease
  • Myelodysplasia
  • Hypothyroidism
  • Hemolysis
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23
Q

What is the most common cause of anemia?

A

Iron deficiency

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24
Q

In a normal RBCs, the central pallor is 1/3 of RBC. What’s the size in an iron deficient RBC?

A

2/3 central pallor

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25
Q

In a sideroblastic peripheral smear, an accumulation of what will be found?

A

Iron deposits

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26
Q

What’s the classic finding of megaloblastic anemia?

A
  • Hypersegmented neutrophils (at least 6 lobes, shouldn’t be more than 5)
  • Oval macrocytes
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27
Q

What test do you order for an Anemia workup?

A
  1. CBC
  2. Reticulocyte count
  3. Peripheral Smear
  4. Check Iron levels
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28
Q

Sickle cell anemia is caused by a mutation of A to T causing what amino acid switch?

A

Glutamic Acid –> Valine

- at position 6

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29
Q

The RBCs in sickle cell anemia “sickle” when stressed by what 3 factors?

A
  1. Hypoxia
  2. Infection
  3. Dehydration
30
Q

Neutropenia is characterized when the neutrophil count is what?

A

<1500/uL

- increases vulnerability to bacterial infection

31
Q

What are the causes of neutropenia?

A
  1. Marrow Disease

2. Peripheral disease

32
Q

Marrow disease is characterized by what?

A
  1. Tumor invasion
  2. Drugs
  3. Marrow Failure
  4. Congenital
33
Q

Peripheral disease is characterized by what?

A
  1. Severe Sepsis

2. Destruction

34
Q

What’s the tx for neutropenia?

A
  1. Find cause
  2. Antibiotics
  3. Infection prevention
35
Q

What are platelets?

A

fragments of megakaryocyte cytoplasm

36
Q

What is the role of platelets?

A

First responder to stop bleeding

37
Q

Disorder when platelet count is too low. How low?

A

Thrombocytopenia

< 150,000/uL

38
Q

Disorder when platelet count is to high. How high?

A

Thrombocytosis

- > 450,000uL

39
Q

A patient with a bleeding disorder could have a problem with what 2 things?

A
  1. Platelets

2. Clotting factor deficiency

40
Q

What are the sequential steps in the Factor 10A coagulation pathway?

A
  1. Prothrombin –> Thrombin
  2. Thrombin causes fibrinogen –> Fibrin
  3. Fibrin monomer –> Fibrin Polymer
  4. Fibrin polymer crosslinks to form 2’ clot
41
Q

Where is the site of bleeding in a clotting factor deficiency?

A

Deep in soft tissues

42
Q

Petechiae are found in what bleeding disorder?

A

Platelet defect

43
Q

Hemarthroses/Muscle hematomas are found in what bleeding disorder?

A

Clotting factor deficiency

44
Q

Where is the site of bleeding in platelet defect disorders?

A

Skin, mucous membranes

45
Q

Ecchymoses (bruising) is ___ in a platelet defect but ____ in clotting factor deficiency

A

small in platelet defect

large in clotting factor def.

46
Q

What’s the most common inherited bleeding disorder? What type of platelet count will this patient have?

A

Von Willebrand’s disease

- normal platelet count, abnormal platelet function

47
Q

vWF protects what clotting factor from being broken down?

A

Factor 8

48
Q

How is vW disease treated?

A

DDAVP - stimulates release of vWF and factor 8

49
Q

Platelets have poor adhesion due to what 3 causes?

A
  1. vW disease
  2. Disorders of aggregation
  3. Disorders of Granule Disease
50
Q

Clotting factor deficiencies are caused by 2 congenital diseases? What factors do they effect in the intrinsic pathway

A
  1. Hemophila A - Factor 8 deficiency

2. Hemophila B - Factor 9 deficiency

51
Q

Heparin affects what molecule in the clotting pathway? What about Warfarin?

A 
Heparin = degrades Thrombin
Warfarin = Factors 2, 7, 9, 10
52
Q

Hemophilia only affects females or males?

A

Males

53
Q

Heparin should only be used in patients who had what?

A

DVT or pulmonary embolism

54
Q

Leukemias involves blood an bone marrow. This is referred to as what type of tumor?

A

Liquid tumor

55
Q

Lymphomas involve lymph nodes and neck swelling. This is referred to as what type of tumor?

A

Solid Tumor

56
Q

In acute leukemia, what types of cells will we see? What % of cells will be “this” on a peripheral smear?

A

Uncontrolled proliferation of immature cells (-blasts)

> 30% of blasts

57
Q

In adults, what % of acute leukemias are myelogenous and lymphoblastic?

A

AML = 80%
ALL = 20%
(reversed in peds population)

58
Q

What are the 2 tx for acute leukemia?

A
  1. Chemotheraphy

2. Bone marrow transplant

59
Q

What hallmark sign will AML have in a peripheral smear?

A

Myeloblast with Auer Rod in cytoplasm

60
Q

What cell will appear large in an ALL smear?

A

Large lymphocytes

61
Q

What’s our major concern in chronic leukemia?

A

Blast crisis = marked increase in the proportion of blast cells

62
Q

Chronic Myelogenous Leukemia has what specific finding?

A

Increased number of circulating neutrophils w/ immature forms in periphery

63
Q

What’s the tx for CML?

A
  1. Bone Marrow Transplantation

2. Imatinib - oral med

64
Q

Most cases of CML have what genetic abnormality?

A

Philadelphia chromosome

65
Q

Chronic Lymphocytic Leukemia has what specific finding?

A

Smudge cells - very small, well differentiated lymphocytes

66
Q

What are the indications for a BMT?

A
  1. Acute leukemia
  2. CML
  3. Multiple Myeloma
  4. Marrow failure
67
Q

What does autologous BMT mean?

A

Stem cells are harvested from patient

68
Q

What does allogenic BMT mean?

A

Stem cells are harvested from matched donor

69
Q

Hodgkin’s Lymphoma is found in ____ patients, while Non-hodgkins is found in ___ patients

A

Younger, Older

70
Q

What type of cell is specific for Hodgkin’s lymphoma?

A

Reed-sternberg cells

71
Q

Multiple myeloma is more common in elderly patients that shows what type of electophoresis?

A

M-spike = albumin and gamma spike

72
Q

A characteristic finding of multiple myeloma are what?

A

Bone lesions (spines hips, etc)

Clinical Medicine 2 (12 decks)

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