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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
In a sideroblastic peripheral smear, an accumulation of what will be found?
Iron deposits
26
What's the classic finding of megaloblastic anemia?
- Hypersegmented neutrophils (at least 6 lobes, shouldn't be more than 5) - Oval macrocytes
27
What test do you order for an Anemia workup?
1. CBC 2. Reticulocyte count 3. Peripheral Smear 4. Check Iron levels
28
Sickle cell anemia is caused by a mutation of A to T causing what amino acid switch?
Glutamic Acid --> Valine | - at position 6
29
The RBCs in sickle cell anemia "sickle" when stressed by what 3 factors?
1. Hypoxia 2. Infection 3. Dehydration
30
Neutropenia is characterized when the neutrophil count is what?
<1500/uL | - increases vulnerability to bacterial infection
31
What are the causes of neutropenia?
1. Marrow Disease | 2. Peripheral disease
32
Marrow disease is characterized by what?
1. Tumor invasion 2. Drugs 3. Marrow Failure 4. Congenital
33
Peripheral disease is characterized by what?
1. Severe Sepsis | 2. Destruction
34
What's the tx for neutropenia?
1. Find cause 2. Antibiotics 3. Infection prevention
35
What are platelets?
fragments of megakaryocyte cytoplasm
36
What is the role of platelets?
First responder to stop bleeding
37
Disorder when platelet count is too low. How low?
Thrombocytopenia | < 150,000/uL
38
Disorder when platelet count is to high. How high?
Thrombocytosis | - > 450,000uL
39
A patient with a bleeding disorder could have a problem with what 2 things?
1. Platelets | 2. Clotting factor deficiency
40
What are the sequential steps in the Factor 10A coagulation pathway?
1. Prothrombin --> Thrombin 2. Thrombin causes fibrinogen --> Fibrin 3. Fibrin monomer --> Fibrin Polymer 4. Fibrin polymer crosslinks to form 2' clot
41
Where is the site of bleeding in a clotting factor deficiency?
Deep in soft tissues
42
Petechiae are found in what bleeding disorder?
Platelet defect
43
Hemarthroses/Muscle hematomas are found in what bleeding disorder?
Clotting factor deficiency
44
Where is the site of bleeding in platelet defect disorders?
Skin, mucous membranes
45
Ecchymoses (bruising) is ___ in a platelet defect but ____ in clotting factor deficiency
small in platelet defect | large in clotting factor def.
46
What's the most common inherited bleeding disorder? What type of platelet count will this patient have?
Von Willebrand's disease | - normal platelet count, abnormal platelet function
47
vWF protects what clotting factor from being broken down?
Factor 8
48
How is vW disease treated?
DDAVP - stimulates release of vWF and factor 8
49
Platelets have poor adhesion due to what 3 causes?
1. vW disease 2. Disorders of aggregation 3. Disorders of Granule Disease
50
Clotting factor deficiencies are caused by 2 congenital diseases? What factors do they effect in the intrinsic pathway
1. Hemophila A - Factor 8 deficiency | 2. Hemophila B - Factor 9 deficiency
51
Heparin affects what molecule in the clotting pathway? What about Warfarin?
``` Heparin = degrades Thrombin Warfarin = Factors 2, 7, 9, 10 ```
52
Hemophilia only affects females or males?
Males
53
Heparin should only be used in patients who had what?
DVT or pulmonary embolism
54
Leukemias involves blood an bone marrow. This is referred to as what type of tumor?
Liquid tumor
55
Lymphomas involve lymph nodes and neck swelling. This is referred to as what type of tumor?
Solid Tumor
56
In acute leukemia, what types of cells will we see? What % of cells will be "this" on a peripheral smear?
Uncontrolled proliferation of immature cells (-blasts) > 30% of blasts
57
In adults, what % of acute leukemias are myelogenous and lymphoblastic?
AML = 80% ALL = 20% (reversed in peds population)
58
What are the 2 tx for acute leukemia?
1. Chemotheraphy | 2. Bone marrow transplant
59
What hallmark sign will AML have in a peripheral smear?
Myeloblast with Auer Rod in cytoplasm
60
What cell will appear large in an ALL smear?
Large lymphocytes
61
What's our major concern in chronic leukemia?
Blast crisis = marked increase in the proportion of blast cells
62
Chronic Myelogenous Leukemia has what specific finding?
Increased number of circulating neutrophils w/ immature forms in periphery
63
What's the tx for CML?
1. Bone Marrow Transplantation | 2. Imatinib - oral med
64
Most cases of CML have what genetic abnormality?
Philadelphia chromosome
65
Chronic Lymphocytic Leukemia has what specific finding?
Smudge cells - very small, well differentiated lymphocytes
66
What are the indications for a BMT?
1. Acute leukemia 2. CML 3. Multiple Myeloma 4. Marrow failure
67
What does autologous BMT mean?
Stem cells are harvested from patient
68
What does allogenic BMT mean?
Stem cells are harvested from matched donor
69
Hodgkin's Lymphoma is found in ____ patients, while Non-hodgkins is found in ___ patients
Younger, Older
70
What type of cell is specific for Hodgkin's lymphoma?
Reed-sternberg cells
71
Multiple myeloma is more common in elderly patients that shows what type of electophoresis?
M-spike = albumin and gamma spike
72
A characteristic finding of multiple myeloma are what?
Bone lesions (spines hips, etc)

Clinical Medicine 2 (12 decks)

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