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Tim's Cards > Hematology III > Flashcards

Hematology III Flashcards

1
Q

How many different blood group systems are there?

How many antigens within these systems?

A

30

600+

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2
Q

What are 2 most important blood group systems?

A

ABO

Rhesus

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3
Q

T/F

The ABO system is protein based

A

False

*Sugar based

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4
Q

What is the most common blood type in the US?

Least common?

A

O+ (37%)

AB- (0.6%)

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5
Q

If type O has both A and B antibodies, why is it the universal donor?

A

The amount is low

*Recipients antibodies matter more

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6
Q

Type A blood group has what antibodies?

A

Anti-B

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7
Q

Type O blood group has what antibodies?

A

Anti A and Anti B

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8
Q

How many Rh blood groups are there?

How many are common?

A

around 50

5 common

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9
Q

What is the most important Rh blood group?

A

Group D

*Determines Rh- or Rh+

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10
Q

What does Rh positive mean?

Rh negative?

A

Rhesus D positive

Rhesus D negative

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11
Q

What blood group is the Universal Donor?

Universal Receiver?

A

O-

AB+

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12
Q

Why is the Rh blood grouping important?

A

High immunogenicity

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13
Q

What is another highly immunogenic peptide blood antigen?

not as much as Rh though

A

Kell

either K+ or K-

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14
Q

Name 2 blood groups that have two types of antigens.

A

Duffy (Fy)
Fy (a+,b+) Fy (a+,b-) Fy (a-,b+) Fy (a-,b-)

Lewis
(a+,b+) (a+,b-) (a-,b+) (a-,b-)

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15
Q

Name 5 blood group systems not including ABO and Rh.

A 
Kell
Duffy
Lewis
Kidd
Ss
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16
Q

Instead of whole anti-coagulated blood, name 5 components blood is processed into.

A 
RBC's
WBC's
Platelets
Fresh frozen plasma
Heat-treated plasma
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17
Q

Broadly, what are 5 detrimental transfusion reactions that can occur?

A 
Hemolytic
Non-hemolytic 
Allergic 
Volume overload
Bacterial transfer
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18
Q

What causes Hemolytic transfusion reaction?

What are 2 consequences?

A

Antigen-antibody rxn

Severe/fatal intravascular hemolysis
Kidney failure

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19
Q

What causes non-hemolytic rxns as a result of blood transfusions?

A

Cytokines

*from damaged blood products

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20
Q

T/F

Non-hemolytic blood transfer reactions are often fatal

A

False

mostly benign

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21
Q

What an an allergic transfer rxn cause?

A

Rashes, itching

*usually benign

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22
Q

What could volume overload of a blood transfusion cause?

A

Pulmonary edema

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23
Q

What can bacterial transfer in blood transfusions cause?

A

Endotoxemia
Septicemia

*potentially fatal

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24
Q

What 3 tests are used in transfusion medicine?

A

Blood grouping (ABO and Rh)
Antibody screen
Cross-Match

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25
Q

What disease can Rh+ babies be born with?

If mother has antibodies

A

Hemolytic Disease of the Newborn

HDN

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26
Q

How is HDN prevented?

A

Drug binds fetal RBC agglutinogens

*immune system never stimulated

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27
Q

Physicians give out Rh immune globulin throughout pregnancy if…

A

Mother Rh-

Father Rh+

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28
Q

What are the drugs (2) that prevent HDN?

A

RhoGAM

Gamulin

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29
Q

T/F

Anemia can be a reduction in Hemoglobin concentration, hematocrit, or RBC count

A

True

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30
Q

What demographic is often affected by mild anemia?

A

Younger patients

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31
Q

What 3 specific deficiencies can cause anemia?

A

Iron
B12
Folate

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32
Q

T/F

TB, lupus, rheumatoid arthritis, AIHA (acquired autoimmune hemolytic anemia) all cause anemia

A

True

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33
Q

What is the most common cause of anemia worldwide?

A

Iron deficiency

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34
Q

What are 2 results of Iron deficiency at the level of the cell?

A

Microcytic (decreased MCV)

Hypochromic (MCH & MCHC decreased)

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35
Q

How do Fe deficient RBC’s appear on a blood smear?

A

Pale
Smaller Cells
Pencilling

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36
Q

What gets Fe from intestinal cell into the blood?

A

Transferrin

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37
Q

What gets Fe from the liver to the spleen?

A

Ferritin

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38
Q

What are 4 causes of Iron deficiency?

A

Blood loss
Decreased Fe absorption (drugs, GI)
Dietary
Increased Fe requirements (growth)

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39
Q

B12 deficiency produce RBC’s that are…

A

Macrocytic

elevated MCV

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40
Q

What are large RBC’s sometimes called?

A

Megaloblasts

“Magaloblastic Anemia”

*B12 deficiency

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41
Q

How does B12 deficiency result in larger RBC’s?

A

B12 needed for Mitotis

Delay in division results in larger cells

42
Q

What is required to absorb B12?

Location?

A 
Intrinsic Factor (IF)
Stomach
43
Q

Lack of B12 because of IF dearth is called…

A

Pernicious Anemia

44
Q

What 2 cells are attacked in a dearth of Intrinsic Factor?

What causes this?

A

Intrinsic Factor cells
Parietal Cells

*Autoimmune

45
Q

What causes chronic atrophic gastritis?

A

Autoimmune attack on Intrinsic Factor and Parietal Cells in stomach

46
Q

T/F

Folate deficiency increases MCV

A

True

*Macrocytic just like B12 deficiency and same pathway

47
Q

T/F

Folate requires Intrinsic Factor to be absorbed

A

False

48
Q

4 things that cause Folate deficiency:

A

Poor nutrition
Increased requirements (pregnancy)
Malabsorption
Drugs

49
Q

Large amounts of blood loss will do what to the heart rate and what to the blood pressure?

A

Increase Heart Rate

Lower Blood Pressure

50
Q

T/F

Blood counts taken after large blood loss are abnormal.

A

False

*concentrations same until plasma replaced

51
Q

If blood is Normocytic, what remains normal?

A

MCV

52
Q

Why does Chronic Kidney Failure cause anemia?

A

No EPO

53
Q

What is the pathophysiology in hemolytic anemias?

A

RBC’s destroyed faster than normal

54
Q

T/F

Hemolytic anemias can be acquired or inherited

A

True

55
Q

What is an example of an acquired hemolytic anemia?

A

AIHA
Acquired Autoimmune Hemolytic Anemia

  • often pts have short lives
  • *Attack on RBC’s own antigens
56
Q

Hereditary anemias are all…

A

Hemolytic

57
Q

In what 3 areas can the pathophysiology of inherited anemias that decrease RBC lifespan occur?

A 
RBC membrane (spherocytosis, eliptocytosis)
RBC enzymes (G6DP)
Hemoglobin (sickle cell, thalassemias)
58
Q

What 4 gene defects can lead to Hereditary spherocytosis?

A

Spectrin
Ankyrin
Band 3 protein
Protein 4.2

59
Q

An elevation in what 2 tests suggests Hereditary Spherocytosis?

A

MCHC (mean cell Hb conc)

RDW (red cell distribution width)

60
Q

Under a microscope, what will Hereditary Spherocytosis look like?

A

Round (no pale center)

Darker (from higher MCHC)

61
Q

T/F

Hereditary Spherocytosis and Elliptocytosis have defects in the same genes.

A

True

62
Q

What does Hereditary Elliptocytosis look like under slide?

A

Kind of like pencilling, with other dark round cells

63
Q

What test can detect Spherocytosis and Elliptocytosis?

A

Osmotic Fragility Test

64
Q

What does the MCF (mean corpuscular fragility) test?

A

50% lysis in NaCl solution

65
Q

Compared to healthy RBC’s, when do spherocytes and elliptocytes lyse in an osmotic fragility test (as solution becomes more hypotonic)?

A

Lyse more readily than RBC’s

66
Q

What is the most common enzymatic disorder of RBC’s in humans worldwide (affects 400 million)?
What type of disorder is it?

A

Glucose-6-Phosphate Dehydrogenase Deficiency

X-linked

67
Q

What does Glc-6-P dehydrogenase do for the RBC?

A

obtain NADPH via PPP

68
Q

What is the function of NADPH in the RBC?

A

maintains Reduced Glutathione

69
Q

What does Glc-6-P dehydrogenase deficiency cause in the RBC?

A

Hemolytic Anemia

*without Glutathione in reduced form membrane becomes unstable

70
Q

What 2 morphologically distinct cells can be visible in a Glc-6-P dehydrogenase deficiency under a microscope?

A 
Heinz Bodies (Olives)
- cluster of denatured hemoglobin

Bite Cells
- Spleen removal of Heinz Bodies

71
Q

What mutation results in sickle cell?

A

Point mutation in Beta-globin

72
Q

What specific AA is affected in Sickle Cell?

Replace with what?

A

AA number six

Glu replaced with Val

73
Q

The defective Hemoglobin seen in Sickle Cell is know as:

A

Hemoglobin S (HbS)

74
Q

In sickle cell, when do RBC’s elongate?

A

Reduced Oxygenation

75
Q

What leads to Sickle Cell Crisis?

A

RBC change shape (low Oxygen)

Vascular occlusion

76
Q

The hemoglobin disorders are know as…

A

Thalassemias

77
Q

What is diminished or absent in Thallasemias?

A

Globin Chains (one or more)

78
Q

What causes chronic hemolysis in Thalassemias?

A

Globin chain excess (due to precipitation within RBC’s)

*due to inability to use chains/unbalanced production

79
Q

T/F

Thallasemias and Sickle cell occur in pretty much the same areas.

A

True

80
Q

How are Thalassemias classified?

A

Gene affected

alpha, etc

81
Q

In Thalassemia, RBC’s are both…

A

Microcytic and Hypochromic

82
Q

What does Leukemia mean?

A

“white blood”

83
Q

Where does the cancer occur in Leukemias?

A

WBC precursors

84
Q

What 2 types of forms does leukemia take?

A

Acute and Chronic

85
Q

Why do patients tend to have reduced number of RBC’s and megakaryocytes?

A

Progressive bone marrow failure

86
Q

What is the most common acute Leukemia affecting adults?

incidence increases with age

A

AML - Acute Myeloid Leukemia

87
Q

What is the Myeloid Line?

A

Neutrophils
Eosinophils
Basophils

88
Q

5 underlying causes of symptoms in AML:

A 
reduced RBC's
reduced WBC's
reduced platelets 
leukemic cells in bones (pain)
Hyperviscosity (resp./neuro problems)
89
Q

What leukemia is most common in childhood and peaks in incidence around 2-5?

A

Acute Lymphoblastic Leukemia

ALL

90
Q

What line is affected in ALL?

A

Lymphoid
(B, T, Nk cells)

*symptoms similar to AML

91
Q

What generally treatable leukemia has a mutation that leads to transcription with high tyrosinase kinase activity?
(affects adults between 40-60)

A

Chronic Myeloid Leukemia

CML

92
Q

What is the chromosomal defect called in CML and where is it found?

A

Philadelphia chromosome

Translocation of 9 and 22

93
Q

What are the 3 phases of CML?

A

Chronic
Accelerated
Blast Crisis

94
Q

What would cause left side pain in the chronic phase of CML?

A

Spleen

95
Q

What is the most common adult leukemia in Western societies that peaks between 60-80?
What is the male:female ratio?

A

Chronic lymphoblastic leukemia
(CLL)

2:1

96
Q

How does a Lymphoma differ from Leukemia?

A

Solid tumor masses

*usually originate in lymphoid tissues like nodes, spleen, etc.

97
Q

What has a more serious prognosis, Hodgkins or non-Hodgkins?

A

Non-Hodgkins

98
Q

What type of cells are present in Hodgkin’s Lymphoma?

A

Reed-Sternberg

“popcorn”

99
Q

T/F
itchy skin, night sweats, unexplained weight loss, enlarged nodes, splenomegaly, hepatomegaly are all symptoms of Non-Hodkin’s lymphoma

A

False.

these are Hodgkin’s
*although both present similarly

100
Q

What are Reed-Sternberg “popcorn” cells?

A

B-lymphocytes that no longer produce antibodies

101
Q

T/F

Both Hodgkin’s and non-Hodgkin’s lymphomas have unknown causes.

A

True

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