Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Low Yield Semmelweis > Hematology - From Slides > Flashcards

Hematology - From Slides Flashcards

1
Q

How many red blood cells I have in the body?

Use

Volume and Normal RBC Count

A

Volume: 5L

RBC Normal Count: 5 T/L or milion per microliter

5x5x10^12 = 25 x10^12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the number of RBC lost in a day? hour? second?

Normal amount in the body: 25 x10^12

RBC Lifespan:120 days

(*Therefore this the amount produced as well)

A

Day: 25 x10^12 / 120 = 2 x 10^11 / day

Hour: 2 x 10^11 / 24 = 10^10 /hr

Second: 10^10/ 3,600 = 3x10^6 /s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the number of WBC lost in a day? hour? second? Relative to RBC

What is the number of Platlets lost in a day? hour? second? Relative to RBC

Number is not nesscesery!

How is it possible?

A

Similar to RBC!

RBC lifespan is higher, Accumulate more but the turnover is the same - Equilibrium!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Two ways of checking the bone marrow?

Location and Aim

A
  • Bone Marrow Aspiration - Sternum, Static Check
  • Bone Marrow Biopsy - Crista Ilia, Function Check
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the differential blood count of WBCs?

A

Neutrophills - 45-70%

Monocytes - 2-8%

Eosinophills - 0-4%

Lymphocytes - 25-45%

Basophills - 0-2%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the Normal WBC blood count?

A

4-10 G/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the Normal PLT blood count?

A

150-400 G/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

“Tornochi Principle” - As cells are differentiating:

  • Cell Size
  • Nuclear/Cytoplasmic Ratio
  • Nuclear Chromatin Density
  • Basophilia of Cell
  • Number of Nucleoli
A
  • Cell Size: ↓
  • Nuclear/Cytoplasmic Ratio : ↓
  • Nuclear Chromatin Density: ↑
  • Basophilia of Cell: ↓
  • Number of Nucleoli:↓
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Definition of Blast Cells:

A

The earliest, Non-Stem cells, precursor that is easilly recognizable with microscope.

(“Tornochi Principle”)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Granulocyte Lineage

Which cell is larger Promyelocyte or Myeloblast?

Which cell is more potent Promyelocyte or Myeloblast?

A

Promyelocyte - Larger

Myeloblast - More Potent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Granulocyte Lineage

Which cell has only eosinophillic kind of granules Promyelocyte or Myelocyte?

A

Promyelocyte - Only Eosinophillic

Myelocyte - Both kinds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Granulocyte Lineage

Which cell has a oval shape nucleus?

Which cell shows the first kidney shape nucleus?

What is the outcome of a Metamyelocyte?

A

Myelocyte - Oval Shape

Metamyelocyte (aka Juvenile)- first show kidney shape

Metamyelocyte turns to Band cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Granulocyte Lineage

What is the first kind of cell that is normal to see sometimes out of the Bone Marrow?

A

Metamyelocyte

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a Left Shift in Granulocyte distribution?

What are the causes?

A

High relative amount of Juvenile and Band cells presence in the blood.

Caused as a response to Infection or by Leukemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is a Right Shift in Granulocyte distribution?

What are the causes?

A

High relative amount of Hypersegmented Neutrophills (5 segements nucleus, Overmature) presence in the blood.

caused by suppression of bone marrow activity, as a hematological sign specific for pernicious anemia and radiation sickness.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Proerythroblasts and Erythroblasts

What is the most dominant visible change in their progression?

also called?

A

Pronormoblasts and Erythroblasts

Becoming more Eosinophilic

More Hb and Less DNA content as it differentiates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Erythroid lineage

What are the names of the subtypes of the normoblast progression?

A

Pronormoblast

↓

Basophillic Normoblast

↓

Intermediate (aka Polychromatophillic) Normoblast

↓

Eosinophilic Normoblast (aka Acidophilic/Orthochromatic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Erythroid lineage

Eosinophilic Normoblast (aka Acidophilic/Orthochromatic) - what will be the outcome of this cell (Next step)?

and after that one..?

A

Reticulocyte

becomes a Mature RBC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Erythroid lineage

What types of the Erythroid lineage cells are present in:

1) The bone marrow
2) Periphery

A

Erythroid lineage

Bone Marrow - All cell steps

Periphery - Reticulocytes and RBCs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Erythroid lineage

What is the significance of elevated amount of Reticulocytes?

How can we recognize them?

A

Can tell us about over or under- production of RBCs

More oval than RBCs with network of ribosomal RNA aka Substancia Reticulofilamentosa (not by Giemsa)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Erythroid lineage

Normal Precentage of Reticulocytes

A

1% in Total RBC Count

but absolute measurement is more Important per individual

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the difference in the amount of WBC and PLT to RBCs?

A

RBC/WBC - 10^3 (Tera to Giga)

RBC/PLT - 10 (Tera to 100 Gigas)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Anemia

What are the Major parameters to check for it?

A

RBC

Hb

Ht

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Anemia

What is MCV?

A

MCV= Ht/RBC

Mean corpuscular volume (MCV) is a laboratory value that measures the average size and volume of a red blood cell.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Anemia

What is MCH?

A

MCH= Hb/RBC

The mean corpuscular hemoglobin , or “mean cell hemoglobin” (MCH), is the average mass of hemoglobin (Hb) per red blood cell (RBC) in a sample of blood.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Anemia

What is MCHC?

A

MCHC= MCH/MCV (actually Hb/Ht)

The mean corpuscular hemoglobin concentration is a measure of the concentration of haemoglobin in a given volume of packed red blood cell.

Because normally Ht is aroud 50% the MCHC is Normally twice as the Hb.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Anemia

What are the implications of a changes of MCH and MCV in anemia?

A

MCH - Hyper/Normo/Hypo-Chromatic Anemia

MCV - Micro/Normo/Macro-Cytic Anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the key findings in Iron Deficiency Anemia (IDA)?

A

Microcytic - MCV↓

Hypochromic - MCH↓

(MCHC is low)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the key findings in Megaloblastic Anemia (Normally from B12/Folate Deficiency)?

A

Macrocytic - MCV↑

Hyperchromic - MCH↑

(MCHC is Normal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Anemia

What is the absolute measurment value of anisocytosis?

A

RDW - Red cell Distribution Width

RDW=MCV/Standard Deviation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Anemia - Tests Significance

Se LDH

Se Bi (Indirect)

Se Haptoglobulin

Coombs Test

A

LDH and Bi - (Uncojugated) ↑ - Hemolytic

Coombs Test - Autoantibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the Reticulocyte Index?

A

_RI = [Reticulocyte(%) * Ht] / [Correction Factor *Norm Ht]_

-The correction factor is based on the abillity of the Bone marrow to release the reticulocytes depending on the Severity of anemia by the Ht.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

RBC with Basophilic Stippling

What does this indicate?

A

Lead Poisning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

RBC - Eliptocytes

What does this indicate?

A

Megaloblastic Anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

RBC - Schistocytes

What does this indicate?

A

Fibrin Fibrills in the blood stream

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

RBC - Howell Jolly Bodies

What does this indicate?

A

Megaloblastic Anemia or Splenectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

RBC - Spherocytes

What does this indicate?

A

Heredetery or by Immune Hemolytic Anemia

38
Q

RBC - Target Cells

What does this indicate?

A

Thalassemia

39
Q

RBCs - Echinocytes (Burr cells)

What does this indicate?

A

Altered lipid in cell membrane
Artifact
Uremia
Piruvate‐kinase deficiency
Aged transfused RBC

40
Q

RBC - Anulocytes

What does this indicate?

A

IDA

41
Q

RBC - Which parasites can live in it?

A

Plasmodium Genus - Malaria

42
Q

Transferrin

What is the meaning of the TIBC and what else will relate to this in it?

A

Transferrin Saturation is the relative iron binding capacity

TIBC is the absulote actuall total Iron Binding capacity

43
Q

What is the initial change in IDA?

A

Serum Ferritin ↓ - Reflects the Storage of Iron in the body.

44
Q

AML, MPN, MDS are all examples for :

A

Malignant Myeloid Groups of Disroders

45
Q

Neutrophills>7.5 G/l with Elevation of Band cells

this is defined as -

A

Neutrophillia caused by infection - Left Shift

46
Q

Eosinophills>0.5 G/l

A

Eosinophillia

47
Q

Leukomoid Reaction

A

Infection causing left shift

ddx from leukemia by markers

48
Q

Granulocytopenia:

General Causes (3)

A

Granulocytopenia:

  • Decreased granulocytopoiesis (aplasia)
  • ​Maturation problem
  • Increased loss of granulocytes
49
Q

Granulocyte count of Granulocytopenia

  • neutrophilic granulocyte count > 1 G/l :
  • 0.5 G/l < count < 1 G/l :
  • count < 0.5 G/l :
A

Granulocyte count of Granulocytopenia

  • neutrophilic granulocyte count > 1 G/l – no symptoms or mild infections
  • 0.5 G/l < count < 1 G/l – increased risk for infections
  • count < 0.5 G/l – severe bacterial and fungal infections, sepsis
50
Q

Major cause of Agranulocytosis

A

Drugs

51
Q

Leukemia

  • What is the difference between Acute and Chronic ?
A

Leukemia

  • Acute - Death without treatment in a few weeks, Undifferentiated white blood cells
  • Chronic - Death without treatment in a few years, Differentiated white blood cells
  • Both are Malignant
52
Q

Leukemia

  • What is a Proliferative Advantage?
A

Leukemia

  • Ineffective inhibition of Proliferation in Malignant WBC due to genetic mutation. “Anti-Social WBC”.
  • This causing Chronic Leukemia
53
Q

Leukemia

  • What is a Maturation Inhibition?
A

Leukemia

  • Differentiation is halted in Malignant WBC due to very high rate of genetic mutation - Causing Acute Leukemia from Chronic Leukemia.
54
Q

Acute Myeloid Leukemia

  • What is a the precentage of Blast cells in Blood and Bone marrow?
A

Acute Myeloid Leukemia

  • Blood > 20%
  • Bone marrow > 20%
55
Q

Acute Myeloid Leukemia

  • WHO Classification: By Pathomechanism (4 types)
A

Acute Myeloid Leukemia

  • AML with reccurent genetic defects
  • AML from MDS/MPN
  • Therapy Induced AML
  • Mixed phenotype (M+L) and NOS (Non-otherwise specified)
56
Q

Acute Myeloid Leukemia

  • Key Symptomes
A

Acute Myeloid Leukemia

  • Hepatosplenomegaly with lymphadenopathy
  • Infections
  • Bleeding tendency
  • Anemia
  • Weight loss
  • DIC / Leukemic Thrombi
  • Osteomyelofibrosis
  • Auer rod in WBC
57
Q

Acute Myeloid Leukemia

  • Diagnosis
A

Acute Myeloid Leukemia

  • Hiatus Leukemicus - In preipheral blood
  • Bone marrow - Blast level > 20%
  • Genetic Abnormalties - Lamda/Kappa Ratio
  • Reciprocal Translocation
  • Immnuophenotyping
58
Q

Myeloproliferative Neoplasms

  • Unique Features
A

Myeloproliferative Neoplasms

  • Differentiated cells in periphery
  • Fibrosis
  • Progression to AML is common
59
Q

Myeloproliferative Neoplasms

  • CML is differentiated from other MPN by -
  • What is the detection method?
A

Myeloproliferative Neoplasms

  • Philadelphia Chromosome Positvity : 9:22 chromosomal translocation - ABL-BCR
  • Abl-BCR gene is detected by FISH
60
Q

Myeloproliferative Neoplasms

  • What are the different forms of Ph Negative MPNs?
  • What is the common mechanism of Mutation?
A

Myeloproliferative Neoplasms

  • Polycythemia vera (PV)
  • Essential thrombocytemia (ET)
  • Idiopathic myelofibrosis (IMF)
  • Other less common forms
  • ​Caused by different JAK mutations
61
Q

Chronic Myeloid Leukemia

  • What is the normal and CML M:E ratio?
A

Chronic Myeloid Leukemia

  • ​Normal - 2:1
  • CML - 30:1
62
Q

Polycythemia vera

Single base pair mutation?

A

Polycythemia vera

JAK2 (vast majority of cases)

63
Q

Polycythemia vera

DDX

A

Polycythemia vera

Polyglobulemia?

  1. EPO↑: Doping, Paraneoplastic, Altitude, Lung/Heart Disease (Mostly COPD), Hemoglobinopathies.
  2. Plasma Volume↓
64
Q

Myelofibrosis and ET

3 common Mutations?

A

Myelofibrosis and ET

JAK2, CALR, MPL

65
Q

Essential Thrombocythemia

DDX

A

Essential Thrombocythemia

MDS, IMF, PV, CML, Bleeding

66
Q

What is the Ph- MPN that is most likely to develop to AML?

A

Myelofibrosis

67
Q

MDS

Classification? (5)

A

MDS

  • SLD: Single lineage dysplasia (Refractory Anemia)
  • RS: Ring Sideroblasts
  • 5q- : Mononuclear megakaryocytes
  • MLD: Multilineage dysplasia
  • EB: Excess Blasts
68
Q

Infectious Mononucleosis

cause? and cell effected?

A

Infectious Mononucleosis

EBV

causes atypical B cells formation to be attacked by T cells

69
Q

Infectious Mononucleosis

Associasion with

A

Infectious Mononucleosis

Burkitts/Hodgkin/B Lymphoma

Nasolaryngelal Carcinoma

70
Q

Infectious Mononucleosis

Diagnosis and DDX

A

Infectious Mononucleosis

DDX: Lymphoma

  1. increased lymphocytes (12‐18 G/L)
  2. presence of at least 10% atypical lymphocytes on peripheral smear
  3. a positive serologic test for Epstein-Barr virus (Paul‐Bunnel
    antibody) .
71
Q

Infectious Mononucleosis

A

Infectious Mononucleosis

Downy Cells

72
Q

ALL and AML

ddx - Incidence as a function of Age

A

ALL and AML

AML mostly in elderly (“Mevogarim”)

ALL mosly in children (“Lo-mevogarim”)

73
Q

CLL

  • Prevelance?
  • Is it common in children? which age?
A

CLL

  • The most common leukemia!
  • Not in Children (at all)! 60-80~
74
Q

CLL

  • Prognosis?
  • Treatment?
A

CLL

  • Many years (more than 10 years)
  • Treatment could resolve the disease with significant side effects
  • Thearpy should start later than other cancers - same effectivity less time with side effects
75
Q

CLL

  • Lymph node Equivalent?
A

CLL

  • Small lymphicytic Lymphoma (SLL)
  • Same immunophenotype and cytogenetics but in SLL there is solid tissue disease.
76
Q

CLL

  • Lymphocyte count suggestive of CLL?
  • What is the effectivity of these lymphocytes in inflammation?
A

CLL

  • The absolute lymphocyte count is > 5 G/L and may be up to 300 G/L - Diagnosis!
  • Very low effectivity - Monoclonal Lymphocytes! (Not specific for infection)
77
Q

CLL

  • What are the surface markers for CLL?
A

CLL

  • CD5+, CD19+ together ! (B and T cell mixed markers)
  • CD23+ - Mental cell lymphoma will have a negative value CD23 - ! (ddx)
  • CD52+ - Prognostic Marker
78
Q

CLL

  • Typical Cells seen in CLL (not diagnostic)
A

CLL

  • Smudge Cells
  • Gumprecht bodies
79
Q

What are the B-Symptoms?

A

B symptoms

  • Fever
  • Night sweats
  • Weight loss
80
Q

Monoclomal Gammopathies

Kinds?

A

Monoclomal Gammopathies

  • MGUS (Bengin - “Undetermined Significance”)
  • Multiple Myeloma
  • Smoldering Myeloma
  • Plasmacytoma
81
Q

Monoclomal Gammopathies

Immunofixation result?

A

Monoclomal Gammopathies

  • Kappa to Lambda ratio is not 50%
82
Q

Monoclomal Gammopathies

Parameter in blood?

A

Monoclomal Gammopathies

  • Monoclonal immunoglobulins
  • aka Paraprotein or M-Protein
83
Q

MGUS

What is the meaning of the diagnosis?

A

MGUS

  • This is a premalignant state!
  • Will progress to Multiple Myeloma - 20% in 15 years
  • Can be prevented!
84
Q

Plasmacytoma

  • Where does the Plasma cells reside?
A

Plasmacytoma

  • Peripheral Plasma cell tumor
85
Q

Multiple Myeloma

  • Where does the Plasma cells reside?
A

Multiple Myeloma

  • In the bone marrow, hence it is a Myeloma
86
Q

Multiple Myeloma

  • Further state for progression of the disease?
A

Multiple Myeloma

  • Plasma cell Leukemia (out to peripheral blood)
  • It is an end stage not many patient reach
87
Q

Multiple Myeloma

  • What is the 5 year survival rate?
A

Multiple Myeloma

  • 35%
88
Q

Multiple Myeloma

  • Clinical Presentation : CRAB
A

Multiple Myeloma

  • HyperCalcemia
  • Renal Insufficiency
  • Anemia
  • Lytic Bone lesions
89
Q

Multiple Myeloma

  • Lab tests results
A

Multiple Myeloma

  • ESR ↑↑
  • M-Peak (also in MGUS) and Hyperproteinemia
  • Anemia
90
Q

Smoldering Myeloma

  • Significant finding (+ddx from M.M)
A

Smoldering Myeloma

  • Plasma cells in the Bone marrow >10%
  • ddx: No clinical symptoms of Multiple Myeloma!
91
Q
A

Low Yield Semmelweis (37 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions