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tsomkapQ > Hematology > Flashcards

Hematology Flashcards

1
Q

What does high WBC and High PMN’s tell you?

A

Stress demargination. (Stress response - post trauma)

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2
Q

What does a high WBC and <5% Blasts tell you?

A

Leukemoid reaction - seen in burn patients or any extreme stress
(extreme demargination looks like Leukemia), Metamyelocytes => Myelocytes

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3
Q

What does high WBC and Bands tell you?

A

Left shift - they have an infection

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4
Q

What does high WBC and >5% Blasts tell you?

A

Leukemia

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5
Q

What does high WBC and B Cells tell you?

A

Bacterial infection

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6
Q

What diseases have high eosinophils?

A 
"NAACP"
N - Neoplasm (Lymphoma)
A - Allergy/ Asthma
A - Addison's disease (no cortisol -relative eosinophilia)
C - Collagen Vascular disease (lupus)
P - Parasites
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7
Q

What diseases have high Monocytes (>15%)?

A 
"STELS"
Syphilis: chancre, rash, warts
TB: Hemoptysis, night sweats
EBV: Teen sick for a month
Listeria: Sick baby
Salmonella: Food poisoning
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8
Q

What do high Retics (>1%) tell you?

A

RBC is being destroyed peripherally

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9
Q

What do low reticulocytes tell you?

A

Decreased production of bone marrow - not working right

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10
Q

What is Poikilocytosis?

A

RBC’s of different shapes

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11
Q

What is Anisocytosis?

A

RBC’s with different sizes

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12
Q

What is the RBC normal lifespan?

A

120 days

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13
Q

What is the RBC lifespan when there is a problem?

A

60-90 days (same time as the shelf life of blood bank units)

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14
Q

What is the Platelet lifespan?

A

7 days

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15
Q

What does “Penia” tell you?

A

Low Levels - (Usually due to virus or drugs)

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16
Q

What does “Cytosis” tell you?

A

High levels

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17
Q

What does “Cythemia” tell you?

A

High levels

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18
Q

What is the difference between Plasma and Serum?

A

Plasma: No RBC’s
Serum: No RBC’s or Fibrinogen

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19
Q

What are the Microcytic Hypochromic Anemias?

A 
Defect in Hb synthesis (RBC small and pale) "FAST lead"
F - Fe Deficiency
A - Anemia of Chronic Disease
S - Sideroblastic Anemia
T - Alpha and Beta Thalassemia's
L - Lead poisoning
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20
Q

What will you see with Iron Deficiency Anemia?

A

Increased TIBC(total iron binding capacity) associated with menses, GI bleeding, and Koilonychia (spooning of nails)

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21
Q

What will you see with Anemia of Chronic Disease?

A

Decreased TIBC (total iron binding capacity)

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22
Q

What will you see with Sideroblastic Anemia?

A

Decreased dALA synthase common with blood transfusions

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23
Q

What will you see with Alpha Thalassemia?

A

Seen in African Americans and Asian Americans (Chromosome 16- deletion)

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24
Q

What will you see in Beta Thalassemia?

A

Seen in Mediterranean’s

chromosome 11- point mutation

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25
Q

What will you see in Lead Poisoning?

A

Decreased dALA dehydrogenase
decreased Ferrochelatase
blue lines on x-ray
history of eating old paint chips

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26
Q

What are the Megaloblastic Anemias?

A

Vitamin B-12 Deficiency
folate deficiency
alcohol

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27
Q

What are some causes of Vitamine B12 deficiency?

A

Tapeworms
Veganism
Type A gastritis
Pernicious Anemia

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28
Q

What are some causes of Folate Deficiency?

A

Old food, you will see Glossitis(inflammation of tongue) with the patient

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29
Q

What is the effect of Alcohol on the fetus?

A 
FAS (Fetal Alcohol Syndrome)
Smooth philtrum (space between nose- mouth, normal people have dimple) 
short
polyclonal
midface hypoplasia
thin superior Vermilion border
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30
Q

What are the Intravascular Hemolytic Anemias?

A

IgM cold autoimmune

G6PD deficiency

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31
Q

What are some causes of G6PD Deficiency?

A

Sulfa drugs, mothballs, fava beans, sudden drop in Hb

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32
Q

What are some causes of Cold Autoimmune?

A

Mono
Mycoplasma infection
Antibody (IgM) bind to RBC’s membrane
cold temp and causes agglutination

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33
Q

What are the Extravascular Hemolytic anemias?

A

Spherocytosis
warm autoimmune
Paroxysmal cold autoimmune
Sickle cell anemia

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34
Q

What is seen in Spherocytosis?

A

Defective Spherin or Ankyrin
Positive Osmotic Fragility test
High level of MCHC (Mean corpuscular hemoglobin concentration)
teardrops cells

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35
Q

What is seen in Warm Autoimmune?

A 
Anti-Rh Ab 
Dapsone
PTU
antimalarials
sulfa drugs

Antibody (IgG) binds to RBC’s membrane in warm temp

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36
Q

What is seen in Paroxysmal Cold Auto Autoimmune?

A

Bleeds after cold exposure Donath-Landsteiner Ab

37
Q

What is seen in Sickle Cell Anemia?

A

Crew-cut on x-ray

Avascular Necrosis of femur

38
Q

What are the Production Anemias?

A

Diamond-Blackfan

Aplastic Anemia

39
Q

What is seen in Diamond-Blackfan Anemia?

A

They have low RBCs and double jointed thumbs

40
Q

What is seen / causes in Aplastic Anemia?

A 
Pancytopenia
Autoimmune
Benzene
AZT (Zidovudine an HIV antiviral drug) 
Chloramphenicol (Ricketsia bacterial infections) 
Radiation
41
Q

What is Basophilic Stippling?

A

Lots of immature cells increased mRNA (seen in lead poisoning)

42
Q

What is a Bite Cell?

A

Unstable Hb inclusions (seen in G6PD Deficiency)

43
Q

What are Burr Cell/ Echinocyte?

A

Seen in

Pyruvate Kinase deficiency
Liver disease
Post splenectomy

44
Q

What is Cabot’s Ring body?

A

Seen in Vitamin B12 Deficiency and lead poisoning

45
Q

What is a Dohle Body?

A 
PMN Leukocytosis (polymorphonuclear neutrophils, also called granulocytes) 
(caused by infections, steroids, tumor)
46
Q

What is a Drepanocyte?

A

Seen in Sickle cell Anemia

47
Q

What is a Heinz body?

A

Seen when Hb precipitates and sticks to cell membranes in G6PD deficiency

48
Q

What is a Howell-Jolly Body?

A

The spleen or bone marrow should have removed nuclei fragments.
(Seen in Hemolytic Anemia, spleen trauma, and CA)

49
Q

What is a Pappenheimer body?

A

Iron inside cell (sideroblastic anemia)

50
Q

What are Pencil Cell/ Cigar Cell?

A

Seen in iron deficiency anemia

51
Q

What is Rouleaux formation?

A

Seen in Multiple Myeloma (Stacked coin look)

52
Q

What is a Schistocyte?

A

Broken RBC (seen in DIC and artificial heart vlaves and others)

53
Q

What is a Sideroblast?

A

Macrophages pregnant with Iron (caused by genetics and or multiple transfusions)

54
Q

What is a Spherocyte?

A

Old RBC

55
Q

What are Spur Cells / Acanthocytes?

A

Lipid bilayer disease

56
Q

What is a Stomatocyte?

A

Seen in liver disease

57
Q

What is a Target Cell/ Codocyte?

A

These have less Hb (seen in Thalassemias or iron deficiency)

58
Q

What is a Tear Drop Cell/ Dacrocyte?

A

RBC’s squeezed out of bone marrow. (Seen in Hemolytic Anemia and bone marrow CA)

59
Q

What do Platelet problems cause?

A

Bleeding from skin and mucosa

60
Q

What do Clotting problems cause?

A

Bleeding into cavities

61
Q

What causes increased PTT and Bleeding Time?

A

Von Willebrand disease and SLE

62
Q

What is Bernard-Soulier?

A

Baby with bleeding from skin and mucosa

Big platelets and LOW GP-1b

63
Q

What is Glanzmann’s?

A

Baby with bleeding from skin and mucosa (LOW GP-2b3a)

64
Q

How does Factor 13 Deficiency present?

A

Umbilical stump bleeding

this is the first time a baby has to stabalize a clot

65
Q

What is a Factor V - Leiden?

A

Protein C cannot break down Factor V

66
Q

How does Von Willebrand Disease (VWD) present?

A

Heavy menstrual bleeding

67
Q

What are the types of VWD?

A 
Type 1 (AD): Decreased VW FActor Production
Type 2 (AD): Decreased VW Activity
(+ Ristocetin Aggregation test)
Type 3 (AR): No VWF
68
Q

What is Hemophilia A?

A

Defective Factor VIII (<40% Activity)

Bleed into cavities (head, abdomen, etc)

69
Q

What is Hemophilia B?

A

Factor IX deficiency

Bleed into joints (knee, etc)

70
Q

What is Polycythemia Vera?

A
  • Hematocrit (Hct) >60%
  • Decreased EPO
  • Budd-Chiari
  • Pruritis after bathing
71
Q

What is Essential Thrombocythemia?

A

Very high platelets increased RBC’s and WBC’s

72
Q

What is Histiocytosis X?

A

Histiocyte proliferation
Kid with Eczema, skill lesions
Hand-Schuller-Christian disease

73
Q

What does the Coombs Test Tell you?

A

Antibody involved

74
Q

What does the Direct Coombs Test tell you?

A

Antibody on surface (seen in hemolytic anemia)

75
Q

What does Indirect Coombs Test tell you?

A

The Antibody is freely circulating in the serum

76
Q

What is Type and Cross?

A

Blood that is matched by blood type and cross-reacted with the patient’s blood for rejection

“A type and screen (T&S) determines ABO blood group and Rh type and screens for clinically significant alloantibodies in case a patient needs blood. A type and cross determines the same information, but additionally performs a crossmatch between the patient’s sample and a unit of blood to prepare a product for immediate transfusion. A type and cross should only be ordered if there is a high likelihood of transfusion.”

77
Q

What is Type and screen?

A

type and screen determines ABO and Rh status of the patient + screens for most commonly found unexpected antibodies.

ABO-RH testing: the “Type”: The patient’s blood cells are mixed with serum known to have antibodies against A and against B to determine blood type.

78
Q

What is Forward Typing?

A

Uses Antibodies to detect Antigens

79
Q

What is Backward Typing?

A

Used Antigens to detect Antibodies

80
Q

What does blood type A tell you?

A

They have the A antigen and B antibodies

81
Q

What does blood type O tell you?

A

They have no antigens (Universal donor)

82
Q

What does blood type AB tell you?

A

Have both Antigens (universal recipient)

83
Q

What does Rh+ tell you?

A

Has D Antigen

84
Q

What does Rh- tell you?

A

Does not have the D Antigen

85
Q

What is Hemolytic Disease of the Newborn?

A

Rh- mom’s blood mixes the Rh+ fetal blood in first pregnancy
No risk to this child
All pregnancies to follow will be a risk, leading to a fetal demise

86
Q

What is RhoGam?

A

Anti-D IgG

87
Q

When do you give RhoGam?

A

1st Dose: Week 28 gestation
2nd Dose: 72 hours post-delivery
Any time a procedure would mix mom and fetal blood

88
Q

What is INR ratio determined by?

A

Measured PT/ Control PT
therapeutic level is between 2-3
Normal level is 1

tsomkapQ (117 decks)

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