Hematology/Immunology Flashcards
1
Q
Cells targeted by FIV & FeLV
A
CD4+ T lymphocytes
2
Q
Major acute phase protein in cats
A
Serum amyloid A
3
Q
What is the next step of a cat with splenic MCT and mast cells in circulation?
A
Splenectomy
4
Q
How to differentiate ALL from lymphoma on flow cytometry?
A
CD34 (generally only present on immature lymphoblasts, absent on mature lymphocytes)
5
Q
Three pathways involved in the complement system
A
- Classical (triggered by C1 bound to antibody/antigen)
- Lectin (lectins bind to PAMPs)
- Alternative pathway (C3 binds directly to pathogen surface)
6
Q
Which molecule enhances antithrombin?
A
Heparin
7
Q
What is the major crossmatch?
A
Recipient serum with donor RBC
8
Q
What is the minor crossmatch?
A
Recipient RBC with donor serum
9
Q
Mechanism of action of folate acid and cobalamin (B12) deficiency-related anemia
A
Folate is essential for DNA synthesis and cellular division, leading to megaloblastic anemia
10
Q
Common RBC morphologic feature seen in cats with DM, hyperthyroidism, lymphoma
A
Heinz bodies
11
Q
Test of extrinsic pathway of secondary hemostasis
A
PT
12
Q
Tests (2) of intrinsic pathway of secondary hemostasis
A
PTT
ACT
13
Q
When should an anemic patient be supplemented with iron?
A
Increased TIBC with concurrent decreased serum iron/ferritin
14
Q
Function of thromboxane
A
Platelet aggregation
15
Q
Bone marrow cytology findings with aplastic anemia
A
Pancytopenia with hypocellular marrow
16
Q
Low platelet count in CKCS
A
Macrothrombocytopenia (beta1-tubulin mutation)
17
Q
Treatment for polycythemia vera
A
Phlebotomy and hydroxyurea
18
Q
Consequence of multiple myeloma which may cause seizures
A
Hyperviscosity syndrome
19
Q
What does RDW indicate on CBCs?
A
Measure of variation in size of RBCs
20
Q
Which of the following is not an antithrombotic
A) Prostacyclin
B) Tissue factor
C) Heparan sulfate
D) tPA
E) NO
A
B
21
Q
Acutely anemic cat with small, cocci-/rod-like RBC adhesions on peripheral blood smear
A
Mycoplasma haemofelis
22
Q
Most common feline blood type
A
Type A
23
Q
First RBC morphologic change seen with iron deficiency
A
Microcytosis
24
Q
When does RBC precursor division stop?
A
Late rubricyte stage
25
Breeds prone to PK deficiency
Basenji, Westie, Cairn Terrier, American Eskimo, Miniature Poodle, Pug, Chihuahua, and Beagle
Abyssinian and Somali
26
Breeds prone to PFK deficiency
English Springer Spaniels, Cocker Spaniels
27
When are leukoerythroblasts found in circulation?
Disorderly release of myeloid and erythroid precursor cells (e.g., myelophthisis, severe infection)
28
Lifespan of canine vs feline RBC in circulation
Dog: 110 days
Cat: 70 days
29
Lifespan of neutrophils in circulation
6-12 hours
30
Lifespan of platelets in circulation
5-9 days
31
Pathogenesis of intravascular hemolysis
C3 deposition, IgM-mediated lysis
32
Which coagulation factors are inhibited by coumadin?
II, VII, IX, X (K+-dependent factors)
33
Cause of hemolytic crisis in a dog with PFK
Hyperventilation (e.g., strenuous exercise)= alkalemia= increased RBC fragility
34
Which form of iron does oxygen bind to?
Ferrous (Fe2+)
35
What are Heinz bodies?
Denaturated and precipitated Hb on the surface of RBC
Sign of oxidative damage
36
What is methemoglobinemia
Iron in Hb is oxidized from Fe2+ to 3+, preventing O2 binding by RBC
37
Mechanisms of action of anemia of CKD
Decreased EPO production, low vitamin B, uremic toxins (inhibit erythropoiesis), iron deficiency, chronic blood loss, shortened RBC lifespan
38
Strongest anticoagulant factor
Antithrombin
39
Most specific marker of regenerative anemia?
Reticulocytes
40
Most immunogenic RBC antigen in dogs
DEA1
41
Mechanism of action of EPO
Binds to EPO receptor on erythroid progenitor cells
42
How often does neutropenia occur in cyclic neutropenia of gray collies?
10-14 days
43
Which coagulation factor is deficient in hemophilia A?
VIII
44
Which coagulation factor is deficient in hemophilia B?
Factor IX
45
In addition to platelet aggregation, name one other major role of TXA2
Vasoconstriction
46
Function of thrombomodulin
Inhibits thrombin and activates protein C (potent anticoagulant)
47
How does multiple myeloma inhibit platelet function?
M component coats platelets, inhibits platelet aggregation, and inhibits release of tissue factor
48
What happens when a type A kitten receives colostrum from a type B queen?
Neonatal isoerythrolysis
49
Which CD molecule binds to LPS?
CD14
50
Function of IL2
Activates naive T cells, produced by Th cells
51
Name 2 antigen-presenting cells (APCs)
Dendritic cells
Macrophages
52
Which cytokines produced by Th2 cells stimulate eosinophils?
IL-4, 5, 10, 13 & TGFB
53
What type of reaction are type II hypersensitivities?
Cytotoxic
Antibody binds antigen on surface of cell and 1) activates complement and formation of MAC
2) Activates ADCC: recruitment of inflammatory cells
54
Example of type II hypersensitivity
IMHA, ITP, pemphigus, type I DM, MG, Addison's
55
What type of reaction are type 1 hypersensitivities?
IgE-mediated
56
Example of type I hypersensitivity
Asthma, flea allergy dermatitis, anaphylaxis, food allergy, atopic dermatitis
57
What type of reaction are type 3 hypersensitivities?
Immune-complex
58
Example of type 3 hypersensitivity reaction
Immune complex GN
Immune-mediated polyarthritis
59
What type of reaction is type 4 hypersensitivity?
Delayed (involves cell-mediated immunity, Th1 activation and recruitment of macrophages via IFN-y)
60
Example of type 4 hypersensitivity reaction
Transplant rejection
Fungal disease (granulomas)
61
Most abundant immunoglobulin in circulation
IgG
62
CD molecules expressed by T cells (3)
CD3, 4, 8
63
CD molecules expressed by B cells (3)
CD79a, 19, 20
64
Molecule important for lymphocyte rolling
Selectins
65
Pyrogens (3)
IL-1, IL-6, TNF-alpha
66
What type of hypersensitivity is post-transfusion hemolysis?
Type 2
67
CpG and LPS are examples of
PAMPs
68
How is the classical complement pathway activated?
C1 binding to antibody (IgG or IgM)/antigen complex
69
Which interleukin stimulates B cells to produce IgE?
IL-4
70
Major enzyme involved in fibrinolysis
tPA (tissue plasminogen activator)
71
Function of GPIIb-IIIa
Integrin responsible for platelet adhesion
72
Exteriorization of which phospholipid triggers coagulation factor assembly
Phosphatidylserine (negatively charged)
73
What does BMBT assess?
Primary hemostasis (platelet function)
74
Most common type of von Willebrand Disease
Type 1 (partial quantitative deficiency of vWF)
75
How do NSAIDs inhibit platelet function?
Inhibition of thromboxane A2 production
76
Mechanisms of thrombocytopenia (4)
Decreased production
Increased consumption
Sequestration
Excessive loss
77
Coagulation factors involved in the intrinsic pathway
XII, XI, IX, VIII
78
Coagulation factors involved in the common pathway
X, V, prothrombin/thrombin (II), fibrinogen/fibrin (I)
79
Coagulation factors involved in the extrinsic pathway
III (tissue factor), VII
80
Function of PAI1 (plasmin activator inhibitor)
Inhibits tPA
81
Mechanism of action of tranexamic acid
Inhibits tPA to inhibit fibrinolysis
82
How do protein C/S inhibit thrombosis?
Inhibition of factor V & VIII
83
Factors inhibited by antithrombin
Thrombin
Factors XII, XI, X, IX
84
Which vitamin K-dependent coagulation factor has the shortest half life?
VII
85
Vitamin K dependent coagulation factors
II, VII, IX, X
86
Protein increased in anemia of inflammatory disease
Hepcidin
87
Differential for microcytic, hypochromic, nonregenerative anemia (3)
Iron deficiency
Copper deficiency
Pyridoxine deficiency
88
Infectious cause of macrocytic nonregenerative anemia in cats
FeLV
89
Causes of secondary erythrocytosis (2)
Chronic hypoxia (e.g., high altitude, chronic pulmonary hypertension, R-L cardiac shunt)
EPO-secreting neoplasms (e.g., renal carcinoma, hepatoma, uterine leiomyoma)
90
When is the nucleus extruded during erythropoiesis?
Metarubricyte
91
At what stage of granulopoiesis do granules become evident?
Myelocyte
92
Which cytokine predominantly controls eosinophil production?
IL-5
93
Which cytokine predominantly controls basophil production?
IL-3
94
Which organ contains 30-40% of circulating platelet mass?
Spleen
95
Mechanisms of effusion/edema formation (4)
Increased venous hydrostatic pressure
Decreased plasma oncotic pressure
Lymphatic obstruction
Increased endothelial permeability
96
Three types of effusions
Transudate (low protein/cell)
Modified transudate (low to mod cellularity, variable protein)
Exudate (high cell count >7000/uL)
97
Biomarker used to confirm chylous effusion
Triglycerides
98
What do ghost cells indicate?
Intravascular hemolysis
99
Cause of eccentrocytes
Oxidative damage
100
Stain used to identify reticulocytes in peripheral blood
New methylene blue
101
4 features of toxic change
Dohle bodies
Basophilic cytoplasm
Foamy cytoplasm
Retention of primary granules
102
Classic feature of TVT on cytology
Cytoplasmic vacuoles
103
Chemotactic factor for neutrophils (produced by macrophages)
IL-8
104
Which macrophage form is involved in the inflammatory response and acts as an APC?
M1
105
Major cytokine involved in M1 macrophage activation
IFN-y
106
First enzyme in the arachidonic acid pathway
Phospholipase A2
107
Enzyme involved in conversion of arachidonic acid to prostaglandins
COX
108
Which T cell recognizes MHCI
CD8 T cells (cytotoxic)
109
Which T cell type recognizes MHCII
CD4+ T cells (helper T cells)
110
Function of Th1 cells
Macrophage activation
111
Functions (2) of Th2 cells
Activate allergic mediator cells (basophils, eosinophils, mast cells)
Activate B cells to produce IgE
112
Function of Th17 cells
Enhance neutrophil response to fungal and bacterial infections
113
Function of Tfh cells
Activate B cells
114
Function of Treg cells
Suppress activities of other effector T cell populations
115
Function of cytotoxic T cells
Kill virus-infected cells
116
Which immunoglobulin has a pentameric structure?
IgM
117
3 types of ELISA
Direct (antigen)
Indirect (antibody)
Sandwich (antigen)
118
Two pathways involved in apoptosis
Extrinsic/death receptor (CD95/Fas)
Intrinstic/mitochondrial
119
Intracellular structure formed by autophagy
Autophagosome
120
Enzyme inhibited by glucocorticoids
PLA2
121
Transcription factor displaced by glucocorticoids
NFkB
122
Mechanism of action of cyclosporine
Calcineurin inhibitor (via binding to cyclophilin)
123
Mechanism of leflunomide
Metabolized to active drug (teriflunomide) which inhibits mitochondrial enzyme DHOOH which is responsible for pyrimidine synthesis in activated T cells
124
Mechanism of action of mycophenolate
Inhibits IMPDH-II needed for guanine nucleotide synthesis in B/T cells
125
Mechanism of action of azathioprine
Metabolized to 6-mercaptopurine-> 6-thioguanine which is incorporated in DNA of B/T cells
126
Mechanism of action of Apoquel
Inhibits JAK1 and IL-31
127
Response elicited by modified live vaccines
Strong cell-mediated and humoral response
128
Response elicited by killed vaccines
Humoral response only
129
Response elicited by vectored vaccines
Cell-mediated and humoral response
130
Major hemoparasite associated with hemolytic anemia in cats
Mycoplasma haemofelis
131
Major hemoparasite associated with hemolytic anemia in dogs and cats
Babesia (gibsoni in dogs, felis in cats)
132
RBC morphology seen with extravascular hemolysis in dogs
Spherocytosis
133
In addition to immunosuppressives, ______ are always indicated in IMHA (except with severe thrombocytopenia)
Antithrombotic therapy (unfractionated heparin +/- antiplatelet agent)
134
Chemotherapeutic which increases platelet release
Vincristine
135
Antigen detected by FeLV ELISA
p27
136
Which feline blood group has stronger alloantibodies?
Type B (strong type A alloantibodies)
137
Blood product options for bleeding prophylaxis in a known vWF patient (2)
Cryoprecipitate
Fresh frozen plasma
138
Type of lymphoma associated with FeLV infection
T cell (usually mediastinal)
139
Most common anatomic form of lymphoma in dogs
Multicentric (84%)
140
Most common lymphoma immunophenotype in dogs
B cell (60-80%)
141
Most common immunophenotype of feline GI lymphoma
T cell (low-grade)
142
Hypercalcemia is commonly associated with which form of lymphoma in cats
Mediastinal
143
Most common immunophenotype associated with nasal lymphoma in cats
B cell (75%)
144
Differentials for generalized lymphadenopathy (5)
Multicentric lymphoma
Disseminated infectious disease (fungal, Brucella, Yersinia, vector-borne)
Immune-mediated (pemphigus, SLE)
Metastatic neoplasia
Other hematopoietic tumors (leukemia, MM)
145
Most common paraneoplastic syndrome in lymphoma
Normochromic, normocytic, non-regenerative anemia
146
What does CHOP stand for
Cyclophosphamide
Doxorubicin
Vincristine
Prednisone
147
Most common immunophenotype associated with CLL
T-CLL (CD8+)
148
Treatment for CLL
Chlorambucil
149
Most common timing for neutrophil nadirs post-chemotherapy
5-10 days
150
Drug associated with later neutrophil nadir
Carboplatin
151
Two chemotherapeutics which are less myelosuppressive (compared to doxo/CCNU/carbo)
Vincristine and cyclophosphamide
152
MDR1 mutations increase risk of myelosuppression associated with all except for:
1. Vinca alkaloids
2. CCNU
3. Doxorubicin
4. Mitoxantrone
2. CCNU
153
Minimum neutrophil count for administration of chemotherapy
1.5K/uL
154
Minimum platelet count for administration of chemotherapy
75K/uL
155
Chemotherapeutic which directly stimulates the CRTZ:
A. Cisplatin
B. Doxorubicin
C. Vinblastine
D. Toceranib
A & B
156
Chemotherapeutic which causes constipation
Vincristine
157
Primary cytokine released by NK cells
IFN-y
158
VW receptor is also known as
GPIb/IX
159
Antithrombin activity during DIC
Decreased
160
Which coagulation factor is also decreased with vWD?
VIII
161
Which receptor is defective in Glanzmann thrombasthenia?
GPIIb/IIIa
162
Congenital failure to exteriorize PS during primary hemostasis
Scott syndrome (GSD predisposed)
163
Hyposegmentation of neutrophils and eosinophils in cats
Pelger-Huet Anomaly
164
Which anticoagulant is vitamin K-dependent?
Protein C
165
Major copper binding protein in plasma
Ceruloplasmin
166
Mechanism of action of heparin
Inhibits factor II and factor X through an antithrombin-dependent mechanism, with subsequent inhibition of factors V and VIII
167
Mechanism of action of clopidogrel
Binds platelet P2RY12 purinergic receptor, inhibiting ADP-mediated platelet activation and aggregation
168
Which complement component is the main opsin?
C3b
169
Neutrophil-mediated killing
Oxygen-dependent generation of ROS
170
Receptor expressed by phagocytic cells which bind to C3b
CD35
171
Function of miRNA
RNA silencing and post-transcriptional regulation of gene expression
172
Which of the following molecules is produced by NK cells?
IL-1
TNF-a
TGF-B
IL-17
TNF-a
173
Which cellular component is targeted by SLE antibodies?
DNA
174
Which of the following cytokines trigger activation of M1 macrophages?
A. IL-1, IL-6, IL-23
B. TGF-B, IL-10
C. IL-4, IL-13
D. IL-22, IL-23, IL-27
A
175
Which TLR binds to ds and ss viral RNA?
TLR3
176
Potent leukotriene responsible for neutrophil migration
LTB4
177
Receptor found on APCs responsible for Th induced activation
CD40
178
Most specialized APC
Dendritic cells
179
Which receptor is deficient in CLAD?
CD18
180
Chelation therapy for zinc toxicity
Calcium disodium EDTA
181
Thrombocytosis is associated with which electrolyte pseudo-abnormality?
Hyperkalemia
