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Pathophysiology 2 > Hematology D/O's > Flashcards

Hematology D/O's Flashcards

1
Q

Blood is a specialized connective tissue of ___________ origin

A

mesodermal/mesenchymal

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2
Q

The process of blood formation is addressed as ____________

A

hematopoiesis/hemopoiesis

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3
Q

________ bones of axial skeleton along with vertebrae (T10-L4) & the skull are the major bones containing _______ _______, generating blood cells

A

Flat bones (sternum, ribs, pelvic bones); bone marrow

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4
Q

_______ is ph balance for blood.

A

7.34-7.45 is ph balance for blood. Lung & Kidney manage acid/base balance for blood

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5
Q

What are some major Fx. of blood? Erythrocytes? Leukocytes? Platelets?

A

carrying oxygen & CO2; maintaining acid/base balance in body; elimination of waste; delivery of nutrients; distribution of hormones & other chemical messengers; clotting & prevention of excessive bleeding; immune defense

  • Erythrocytes = O2 & CO2 transport
  • Leukocytes = Defense & Immunity
  • Platelets = Blood clotting
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6
Q

Blood is made up of ________; ________ & _______

A

Erythrocytes (RBC’s); Leukocytes (WBC’s) & platelets (blood clotting factors)

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7
Q

What is the difference between red bone marrow & yellow bone marrow?

A

(Myeloid) - Red marrow is made up of immature blood cells and can be found in flat bones of the body; yellow marrow is made up of fat cells & supports/nourishes adipose connective tissue for myeloid.

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8
Q

What is myelophthysis?

A

myelophthysis is the degeneration of active bone marrow (myeloid) & substitution of yellow marrow (fat)

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9
Q

__________ from the kidneys – increases the # of RBC precursors.

A

Erythropoietin (EPO)

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10
Q

________ from the liver – stimulates the formation of platelets. TPO mRNA is expressed mainly in the liver, & to a lesser extent in kidney, spleen, lung, bone marrow, and brain, (smooth muscle).

A

Thrombopoietin (TPO)

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11
Q

_________ (DHT or active form of testosterone) stimulate

production of erythrocytes (RBCs). It explains higher Hematocrit in males versus in females.

A

Androgens - Normal Hct values are approximately 37-46% in females, & slightly more as 41-53% in males (due to active testosterone influence).

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12
Q

____-____ _____ or interleukins stimulate WBC formation.

A

Colony-stimulating factors (CSFs)

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13
Q

___________ is an excessive amount of cellular blood cells

A

polycythemia:
* can be relative - bc of loss of fluid, ex. vomiting, diarrhea, heat, not enough drinking of water, severe burns

  • or absolute - when bone marrow generates more than necc. RBC’s - caused by bone marrow cancer -** primary absolute polycythemia - polycythemia rubra vera

** or secondary absolute polycythemia - can be KD cancer bc of erythropoeitin — or bc of oxygen deprivation aka hypoxia

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14
Q

_______ ________ Disease is the most common genetic bleeding disorder

A

Von Willibrand Disease (clotting factor VIII) - a glycoprotein, manufactured by the endothelium of the blood vessels as
well as by the liver…indistinguishable from Hemophilia clinical presentations

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15
Q
  1. Initial brief vasospasm, 2. Temp. platelet plug formation, 3. coagulation cascade, 4. clot retraction & 5. clot dissolution are the steps for a ________ ______
A

coagulation cascade (goal is to create fibrin)

  • Intrinsic - inside of blood vessel injury
  • Extrinsic - crashed tissues
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16
Q

_________ (increased WBC count): unless stated otherwise, should be understood as neutrophil count increase (neutrophilia): suspect acute bacterial infection 1st, followed by acute inflammation, necrosis, pregnancy, stress.

A

Leukocytosis

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17
Q

__________ (decreased WBC count): immunodeficiency, predisposing to overwhelming bacterial (pyogenic) infections

A

Leukocytopenia

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18
Q

_________ (increased eosinophil count): parasitic infections, allergies

A

Eosinophilia

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19
Q

_________: allergies

A

Basophilia

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20
Q

__________: transient (episodic) will most commonly signify viral infection, persistent should be evaluated for auto-immune pathologies, or, if the cells are immature, for white blood cell malignancies.

A

Lymphocytosis

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21
Q

________: usually associated with immunodeficiency

A

Lymphocytopenia

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22
Q

________ (an increase in reticulocyte count): an indication of anemia or hypoxia (an organism needs more oxygen): suspect chronic bleeding; respiratory pathology; smoking, change of altitude; convalescence stage (recovery). Blood is not stewy yet like in Polycythemia.

A

Reticulocytosis - precursor for Erythrocyte

23
Q

________ (increase in immediate precursor cells for neutrophils): suggests initial stage of an acute bacterial infection.

A

Bandemia

24
Q

_______ - determines volume or size of RBC’s in CBC

A

MCV - Mean Corpuscular Volume - 80-95 is normal

25
Q

_____ - determines color & depends on hemoglobin concentration in cell

A

MCH (27-31 pg) or MCHC (32-36 gm) - Mean Corpuscular Hemoglobin Concentration -

26
Q

_________ width is cell congruent or polymorphic - like in sickle cell

A

RCD - Random Cell Distribution width

27
Q

What does it signify when a patient has neutrophilia?

A

Acute bacterial infection 1st; followed by acute inflammation; necrosis; pregnancy; or stress

28
Q

What is the most common cause of transient lymphocytosis?

A

viral infection, persistent can be auto-immune pathology and if immature cells then check for WBC malignancies

29
Q

______________: characterized by smaller cell size (diminished MCV) & poor Hb content (pale cells): it is usually due to deficient Hemoglobin production. The major & most common microcytic anemia is due to Iron deficiency!!! The major etiology of Iron deficiency anemia is chronic (insidious) blood loss!!!

A

Microcytic and hypochromic; heavy menses is main culprit for women and GI tract bleeding is main culprit for men.

30
Q

____________: it is usually due to deficient DNA production, which contributes to inability of RBCs to mature, so they are arrested in a larger size with increased MCV. The most common etiology is due to deficient B12 or Folate content

A

Macrocytic (megaloblastic) - some jaundice/icteris might be present

31
Q

_____ ___ ___ (the most common type of anemia, which is most commonly originated from an insidious blood loss): characterized (among other general anemia features, displayed above) by pica, pagophagia, koilonychia, & glossy tongue. The RBCs appear pale and small (microcytic and hypochromic).

A

Iron Xu Anemia

32
Q

_______ anemia of any origin: prominent jaundice!!!

A

Hemolytic

33
Q

______ of ___ ____: normal RBCs but diminished count/ Hematocrit.

A

Anemia of chronic disease

34
Q

_____ or _____ Deficiency: large red blood cells due to deficient cellular DNA; slight jaundice

A

B12( Homocystein found in blood/prone to ischemic Heart disease) or Folate (methonine/methyl-malonic acid found in blood)

*in these cases a gastroenterologist needs to be involved

35
Q

________ test is most frequently used along with serum Iron test to evaluate either Iron deficiency or Iron overload conditions. ______ is used to calculate the transferrin saturation by Iron. In healthy individuals, about 20-40% of available transferrin sites are saturated by iron.

A

Total Iron-binding Capacity (TIBC)

36
Q

Patients, who suffer with chronic auto-immune atrophic
gastritis (the etiology remains obscure & usually noted as familial disease), are unable to produce Intrinsic Factor complex as carrier molecules for cyanocobalamin
(Vit. B12) absorption through the mucosal barrier of jejuno-ileum. This complex is produced by parietal cells of the stomach, which are atrophied in this condition. This PARTICULAR MALABSORPTION B12 Deficiency Anemia is addressed as _______ ______. It is considered as a
very strong prerequisite to gastric cancer.

A

PERNICIOUS ANEMIA

37
Q

____ ____ _____ is a hereditary hemolytic anemia, which is caused by a point mutation on the gene, coding for beta-chain of adult Hemoglobin A. It is of an autosomal-recessive inheritance mode.

A

Sickle Cell Anemia - glutamic acid is substituted by valine at position 6 of a betachain in Hemoglobin molecules, leading to production of Hemoglobin S instead of Hemoglobin A which leads to sickling (ice picks). —major pathogenesis of SC anemia is generalized hemolysis with thrombosis & ischemia

38
Q

How is Iron Deficiency diagnosed?

A

Major storage source of iron, FERRITIN is measured; binding of iron to TRANSFERIN is measured as TIBC. In iron deficiency the storage of iron aka Ferritin is depleted while TIBC is increased.

39
Q

Deficiency of ______ leads to accumulation of pro-inflammatory substance amino-acid homocysteine. This substance contributes to vascular injury and eventually to chronic ischemic heart disease & other chronic vascular pathological events.

A

Vitamin B12 - known to result as well in significant neurological deficit which can be irreversible: peripheral neuropathies, dementia, & loss of coordination

40
Q

_______ and normochromic: suspect anemia of chronic disease like congestive heart failure or acute blood loss

A

Normocytic

41
Q

_____ _______ disease: caused by genetic defect of different inheritance mode (mostly AUTOSOMAL) of a gene, coding for Von Willebrand factor production. May present as qualitative or quantitative deficiency of vWF molecules. This is the most common genetic bleeding disorder.

A

Von Willebrand - very similar to hemophilia in its clinical presentations. However, it has more relevance to heavy menstrual bleedings along with spontaneous bleeding &
thrombosis. It should be differentiated with other bleeding D/O’s by essaying certain clotting factors & investigating bleeding times.

(Differential Diagnosis for Menorrhagia)

42
Q

Hemophilia_____ & ____ are both hereditary X-linked recessive disorders of predominantly males. They are caused by mutations of the genes, which code for clotting factors VIII and IX respectively.

A

Hemophilia A and B

  • Hemophilia A (xu of clotting factor VIII) - most common.
  • Hemophilia B (xu of clotting factor IX) is otherwise known as Christmas disease by the name of the first patient described.
  • Both are clinically indistinguishable & characterized by spontaneous or post-traumatic excessive bleeding, muscle hematoma formation, bleeding in multiple joints (hemarthrosis).
43
Q

The most common Leukemia of childhood is ___ ____ ____

A

Acute Lymphocytic Leukemia (ALL)

44
Q

___________ absolute Polycythemia aka Polycythemia rubra vera is myelo-proliferative D/O of the bone marrow itself - sort of red blood cell cancer.

A

Primary

45
Q

___________ absolute Polycythemia could be due to KD cancer, producing an excessive amount of erythropoieitin or any circumstances when body is starving for oxygen

A

Secondary

46
Q

Philadelphia chromosome has to do with a mutual translocation of chromosomes _____ & ____. It is the most prevalent in Chronic Myelogenous or myeloid leukemia (CML) and is found in 95% of cases of & 5% of cases of ALL

A

9 & 22

47
Q

Hodgkin’s lymphoma is characterized by relatively specific finding of so called ____-_____ bi-nucleated cells, found w/in the parenchyma of lymph nodes, spleen & liver.

A

Reed-Sternberg cells — Hodgkins (SOLID) & Non-Hodgkins (SOLID & LIQUID) lymphoma are both malignant but NON-HODGKINS lymphoma might have leukemia component as well

48
Q

T/F Platelets have a nucleus.

A

False, platelets have a cell membrane but NO nucleus & can’t reproduce

49
Q

T/F Serum does not contain fibrinogen.

A

True, serum is plasma w/o fibrinogen. Fibrin strands of clots squeeze serum (plasma without fibrinogen) from the clot & cause it to shrink at the end of a hemostasis process.

50
Q

Of the coagulation factors synthesized in the liver, factors
II, VII, IX, and X & prothrombin require the presence of vitamin ____ for normal activity. In vitamin ___ deficiency, the liver produces the clotting factor, but in an inactive form. Vitamin ____ is a fat-soluble vitamin that is continuously being synthesized by intestinal bacteria.

A

Vitamin K

51
Q

The _____ falls in microcytic (small cell) anemia and rises in macrocytic (large cell) anemia. Some anemias are normocytic (i.e., cells are of normal size or MCV).

A

MCV - Mean Corpuscular Volume

52
Q

The ______ is the concentration of hemoglobin
in each cell. Hemoglobin accounts for the color of red blood cells. Anemias are described as normochromic (normal color or _____) or hypochromic (decreased color or ______).

A

MCHC - Mean Corpuscular Hemoglobin

Concentration

53
Q

______ refers to the mass of the red cell & is less useful in classifying anemias

A

MCH - Mean Cell Hemoglobin

Pathophysiology 2 (4 decks)

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