hematology Flashcards
woman from middle east …. grayish skin, hepatomegaly, massive splenomegaly, and edema
anemia and leukocytes less than 4000
sandfly
leishmanias
KALA AZAR
ixodes tick transfers
babesiosis , lyme, erichiliosis
anopheles mosquito
malaria
aedes mosquito
flavivirus—- yellow fever and dengue
Defective actin cytoskeleton formation
wiskot aldrich .. WASp … XLR
disorder of B and T cells
eczema pyogenic infections thrombocytopenia
Impaired migration and adhesion to the vascular endothelium
LFA-1 integrin (CD18) on the surface of leukocytes, which impairs their ability to bind intracellular adhesion molecules (ICAMs) on the vascular endothelium.
Microtubule dysfunction with failure of phagosome-lysosome fusion
partial albinism with hypopigmentation of the skin, eyes, and hair.
chediak higashi … LYST
soldier myalgia diarrhea stomach pain…
liver enlarged and spleen enlarged
eosinophilia
katayama fever
unsanitary drinking water
schistosoma mansoni
txt - praziquantil
trichinella symptoms and what causes it
Trichinella infection would cause muscle inflammation and periorbital edema.
undercooked meat
dissolve clot mechanism and drug
alteplase reteplase ….
plasminogen to plasmin
pancytopenia , nosebleeds, deformed thumbs, other skeletal abnormalities
fanconi anemia
txt with bone marrow transplant
age of diagnosis - around 8n yrs
congenital pure red cell aplasia …. cleft lip … shield chest… webbed neck,,, short stature
diamond blackfan syndrome\txt with setroids
decreased surface expression of glycoprotein Ib
bernard soulliere …. increased BT
plateltes dont have glycoprotein IIb IIIa receptor
glanzman
what is a hapten give example
a moleculre that cannot induce an immune response on its own but when it binds to a protein it can activate helper T cell
penicillin induced hypersins reaction … type II .. pt presents with fatigue splenomegaly pallor
sickle cell anemia shifts oxxygen curve to
the RIGHT
auer rods are +ve for?
myeloperoxidase
prognosis of AML what can happen
auer rods can disseminate … activate coag cascade throughout the body… causing platelet-fibrin microthrombi …. can damge passing RB
hemolytic anemia and DIC
increased INR means?
blood taking longer to clot … so if pt taking warfarin check for CP450 inhibitors
SICKFACES.COM
is hogkin lymphoma a neoplasm of stem cells ?
no
thats why pt can use autologous grafts ( taken from other parts of body)
least likely to be rejected
a short-acting anesthetic that potentiates chloride through GABA-A receptors
propofol
This explains the rapid onset and short duration of action
high lipid solubility
redistribution
58 man …..small tense vesicles, bullae and erosions over the dorsal aspect of both forearms and hands.
tea coloured urine
PCT
defect in enzyme…. uroporphyrinogen decarboxylase in cytoplasm
effective way to reduce the incidence of catheter-related bloodstream infections and has minimal adverse effects; it is recommended for all patients in the ICU.
daily chlorhexidine bathing
increased HbF ,,, decreased HbA2,,,,,, NO hbA1
b thalassemia major
due to complete absence of A1
define Hb A1
means 2 alpha 2 beta
pt has a history of DVT … comes in the clinic and is started on intravenous anticoag …. develops severe thrombocytopenia and increased PTT bleeding time
also large brusies can be noted
this is heparin induced thrombocytopenia
antibodies to platelet factor 4 develop and bind heparin… they activate platelets and cause thrombosis
TXT with direct thrombin inhibitos ARGATROBAN or bivalirudin
abdominal pain, nausea, hematemesis, hypotension, and tachypnea are signs of
acute iron overload
a child has really high WBC count
sea of blast cells seen on smear
fatigue night sweats fever seen
what is the diagnosis and what else could be seen in blood test
ALL
blast crises …. leads to neutropenia
marginal zone
B cells in spleen
which viruses have humoral response ONLY
RIP
killed vaccines
rabies influenza (intramus) polio salk and hepA
ristocetin test
The ristocetin factor activates vWF to bind the platelet receptor gylcoprotein Ib (GpIb). When ristocetin is added to normal blood, it causes agglutination. Failure of aggregation with ristocetin assay occurs in von Willebrand disease and Bernard-Soulier syndrome.
pregnant woman….. complains of shivering and chills …. develops ecchymoses on legs …. low BP
inadequate bleeding control
amniotic fluid embolism
DIC
thrombocytopenia ,… increased BT PT PTT
acanthocytes
are also known as spur cells and are found in liver disease and abetalipoproteinemia
inhibition of porphobilinogen deaminase
acute intermittent porphyria
treated for meningitis in russia
signs of aplastic anemia
chloramphenicol
preferred anticoagulants in the setting of AF.
Direct factor Xa inhibitors (rivaroxaban, apixaban, and edoxaban) or dabigatran (a direct thrombin inhibitor)
osteomyelitis in sickle cell patient
salmonella … capsule is virulence
ITP what can be seen in peripheral blood smear
large platelets
RBCs with cytoplasmic basophilic remnants
howell joley bodies … in aasplenic pts
medulla of the lymph node house the cords n sinuses
contain b cells and plasma cells
sinuses contain reticular cells n macrophages
taut hb
deoxy form …. peripheral capillaries
MGUS diagnosis
no CRAB symptoms
m protein <3g/dl
classical complement pathway can be triggered by igM or igG after binding to a specific part on the ig …. where is this
CH2 Fc portion of heavy chain
VH and VL, on the Fab fragment, that together are known as
antigen bindng domain
pregnant woman … DVT what meds to use
enoxaparin over LMWH
after 37 weeks of gestation LMWH can be used
5 Ps for AIP
porphobilinogen deaminase painful abd port wine urine psychological polyneuropathy precipitated by drugs (alcohol starvation)
Aminolevulinate synthase deficiency
XL sideroblstic anemia
which type of graft rejection presents with erythematous macules and papules all over body
GVHD
5 weeks
mechanism of MTX
DHF to THF
inhibits dehydrofolate reductase
signs and symptoms of spontaneous bleeding, purpura, elevated levels of PT and PTT, and decreased fibrinogen are signs of …..
which leukemia is this assoc with?
DIC
AML t 15 17
mother has a mechanical heart valve,
gives birth to a child nasal and midface hypoplasia; shortened limbs and digits; calcifications of the vertebral, humeral, and femoral epiphyses
what meds was she taking?
warfarin
long term anticoag due to valve
warfarin can cross the placenta
chronic lymphocytic leukemia (CLL) is a low-grade malignancy of
b cells
CD 23 5 20
CLL can progress to
autoimmune hemolytic anemia
blast crisis in which type of leukemia
CML —- ALL OR AML blast crises
richter transformation
CLL —– DLBCL which is an aggressive lymphoma
intrinsic apoptosis pathway
BCL2 BCLx are antiapoptotic molecules that prevent release of cytochrome c
BAX and BAK are proapoptotic that can trigger release of the cytochrome c
extrinsic apoptosis pathway
binding of FasL to Fas and TNF-α to its receptor or the release of perforin and granzyme B in immune cells activate caspases.
most common antibiotic to cause aplastic anemia
chloramphenicol … binds 50s
low serum iron low TIBC high ferritin \+dsDNA and high creatine diagnose and treat
anemia of chronic disease
due to SLE nephropathy
give EPO
how is the majority of CO2 transported
plasma as hCO3-
Spike and dome” on electron microscopy is associated with
membranous glomerulonephritis
subepithelial deposits
risk factors for an ischemic stroke
. Risk factors include hypertension, high cholesterol, cigarette smoking, advanced age, and diabetes mellitus
txt for ischemic stroke
ADP inhibitors
clopidogrel ticagrelor
how to calculate corrected reticulocyte count for a pt with EPO def
reticulocyte count x pt hct/normal hct
highly mitotic, basophilic lymphocytes, surrounding clear zones of macrophages
biopsy from abdoiminal mass
Burkitt 814 cmyc
starry sky
T cell acute lymphoblastic leukemia
T-ALL, Thymic mass, Teenagers, Testosterone (more likely in males).
light blue, scanty, and nongranular cytoplasm
lymphoblasts
anemia in SLE
Anemia in patients with SLE is most commonly caused by anemia of chronic disease or autoimmune hemolytic anemia. Autoimmune hemolytic anemia is caused by a type II hypersensitivity reaction and presents with an increased reticulocyte count, spherocytes on peripheral blood smear, and a positive direct antiglobulin (Coombs) test.
PGI2 function
Prostaglandin I2 (PGI2) inhibits platelet aggregation, causes relaxation of smooth muscle, reduces systemic and pulmonary vascular resistance by direct vasodilation, and causes natriuresis in the kidneys.
baby 8 months old has anemia
drinks breast milk and produces normal wet diapers
iron def
after 6 months iron must be given with diet — as in formula milk or solid food
describe schilling test in context of pernicious anemia
stage 1 –oral b12 … if in urine means absp is OK if not in urine go to stage 2
stage2 —radiolabeled b12 and IF given … now if b12 in urine diagnosis is pernicious anemia because the issue was with IF … if still no b12 in urine then problem with malabsp
commonly used in the treatment of myeloproliferative disorders such as polycythemia vera and essential thrombocythemia, as well as sickle cell disease.
hydroxyurea
partially double-stranded DNA virus that is found to have RNA-dependent DNA polymerase.
hep B
has an RNA-dependent DNA polymerase (reverse transcriptase). however, is an RNA virus
HIV
with a severe normocytic anemia, ptosis, and double vision.
MG
thymoma
low erythroblasts as it caauses pure RBC aplasia
why is sulfamethoxazole CI in pregnancy
Sulfamethoxazole is contraindicated in pregnancy because it binds to albumin and can displace unconjugated bilirubin, leading to cerebral toxicity in the fetus.
damages basal ganglia
is used for anticoagulation in patients with heparin-induced thrombocytopenia
argatroban
direct thrombin inhibitor
patient presents with weight loss, signs of anemia, generalized lymphadenopathy, and hepatosplenomegaly
non-Hodgkin lymphoma often involves multiple lymph nodes, while extranodal involvement is also common.
(mutation in IL-2R gamma chain)
scid
ymphocyte apoptosis due to increased intracellular dATP)
scid … adenosine deaminase def
bleeding from different parts of her body, throbbing and burning in her hands and feet, and an enlarged spleen
platelet count high only
Essential thrombocythemia
co admin of cyclosporine and erythromycin will have wha effect
macrolides are CP450 inhibitrs
so increase levels of cyclosprn
how does GCSF work
binds to the SURFACE RECEPTOR in bone marrow cells
CD16
CD16 is found on natural killer cells
overproduction of antiapoptotic protein happens in wch type on non hodgkin lymphoma
follicular
t 14 18
BCL2
an overactive transcription factor.
ewing sarcoma
11 22
pt has seizure … given a med and comes back with macrocytic anemia … wat meds is he taking
phenytoin
folate def
warm reactive autoimmune hemolytic anemia with spherocytes treatment
corticosteroids
b7 marker
on APC that interact with CD28 on t cells
CD28
t cells
CD40
macrophages
CD56
NK cells
CD34
human stem cells
inhibits IMP dehydrogenase
mycophenolate
mechanism of griseofulvin
disrupts microtubule
acute anticoagulation use
heparin
to prevent MI use
aspirin
chadvasc score of 2 or more .. afib pt …
warfarin
apixaban rivaroxaban dabigatran
steven johnson syndrome caused by
s allopurinol, acetaminophen, ibuprofen, penicillin, and anticonvulsants.
sunburn like rash is a hallmark feature for
TSST
staph toxic shock syndrime
Gastrointestinal (nausea/vomiting)
Muscular (myalgia with elevated creatine phosphokinase level)
Renal (elevated serum blood urea nitrogen and/or creatinine levels, or pyuria)
Hepatic (elevated aspartate aminotransferase, alanine aminotransferase, and/or bilirubin)
Hematologic (platelet count <100,000/mm3, leukocytosis)
Central nervous system (altered mentation/consciousness without focal findings).
folate fujnction in the body
transfer carbon
transplant patient presents with vessel occlusion, ischemia ,fibrinoid necrosis which type of reaction is this
hyperacute
Recipient antigen-presenting cells presenting donor peptides after transplant
chronic rejection
acute graft rejection
recepient cytotoxic t cells
only against SOLID transplants not bone marrow
Daclizumab
Dacluzimab is an interleukin-2 receptor antagonist
reatment of acute myelogenous leukemia (AML).
Daunorubicin (intercalate between strands of DNA) and cytarabine (pyramidine analogue)
CLL treatment
Fludarabine and rituximab
doxorubicin SE and prophylaxis
dexrazoxane iron chelating
dialated cardiomyopathy
plummer vinson
esophageal webs
iron def anemia
atrophic glossitis
Broken and destroyed lymphocytes
smudgec ells
CLL
Mutations in the phosphatidylinositol glycosyltransferase gene
PIGA gene
PNH
A prolonged partial thromboplastin time (PTT) that is corrected by fresh-frozen plasma
in hemophilia for example
female reports many miscarriages
joint pain
weight loss
+ve RPR but negative treponemal test
antiphospholipid syndrome
+ve B2glycoprotein
and crdiolipin (igM igG)
when to use FFP
extrinsic pathway problems … like overdose with wrfarin
cryoprecipitate
this has factor 1 (fibrinogen) that is converted to fibrin …. use this in DIC
HLA3
hemochromatosis
HLAB8
addison
Myasthenia
Graves
HLADR5
hashimoto
pernicious
Splenic macrophages consuming RBCs with IgG bound to the surface is seen
in warm autoimmune hemolytic anemia, which would present with anemia with splenomegaly and jaundice. There would be marrow hyperplasia with a corrected reticulocyte count > 3%.
CD 14 is a marker on
macriphages
aspirin mechanism
irresversibly inhibit COX 1 COX 2
pegylated interferon (IFN) for hep b
he most worrisome complications include bone marrow suppression, resulting in cytopenias (eg, neutropenia) and life-threatening infections, neuropsychiatric symptoms, worsening of autoimmune disorders, and ischemic disorders.
