Hematology Oncology Flashcards
Anisocytosis/poikilocytosis
varying sizes/varying shapes
Dense granules of platelets
ADP, calcium
Alpha granules of platelets
vWF, fibrinogen
vWF receptor
Gp1b
Fibrinogen receptor
GpIIb/IIIa
Macrophage surface cell marker
CD14
Hypersegmented neutrophils indicate…
B12/folate deficiency
causes of eosinophilia
NAACP Neoplasia Asthma Allergic processes Connective tissue disease Parasites
Cromolyn sodium
prevents mast cell degranulation (asthma prophylaxis)
Surface receptors of dendritic cells
MHC II, Fc Receptor
costimulatory signal necessary for T cell activation
CD28
CD8 recognizes
MHC I
CD4 recognizes
MHC II
Class of Anti-A and Anti-B antibodies
IgM (don’t cross placenta)
class of anti-Rh antibodies
IgG (cross placenta)
Deficient in Hemophilia A
factor VIII
Deficient in Hemophilia B
factor IX
Extrinsic pathway
VII
Intrinsic pathway
XII, XI, IX, VIII
Common pathway
X, V, II
Vit K dependent
X, IX, VII, II
Primary antithrombin targets
II, X
Ticlopidine & clopidogrel inhibit…
ADP-induced expression of GPIIb/IIIa
Abciximab inhibits…
GPIIb/IIIa directly
Ristocetin
activates vWF binding to GpIb
Incr ESR (5)
infections, autoimmune, malignant neoplasm, GI disease, pregnancy
decr ESR (5)
polycythemia, sickle cell, CHF, microcytosis, hypofibrinogenemia
Assoc with acanthocyte
liver disease, abetalipoproteinemia
Assoc with basophilic stippling (4)
anemia of chronic disease, alcohol abuse, lead poisoning, thalassemias
Assoc with bite cell
G6PD def
Assoc with macro-ovaolcyte
magaloblastic anemia, marrow failure
Assoc with schistocyte
DIC, TTP/HUS, traumatic hemolysis
Assoc with spherocyte
hereditary spherocytosis, autoimmune hemolysis
Assoc with teardrop cell
bone marrow infiltration; myelofibrosis
assoc with target cell (4)
HbC disease, asplenia, liver disease, thalassemia
Cause and assoc Heinz body
denatured Hb; G6PD, a-thalassemia
Cause and assoc Howell-Jolly bodies
nuclear remnants; asplenia
Microcytic anemias (5)
iron deficiency, ACD, thalassemias, lead poisoning, sideroblastic anemias
Plummer-Vinson syndrome
iron deficiency anemia, esophageal webs, atrophic glossitis
a thalassemia: cis vs trans deletion
Asian/African
4 allele a thalassemia
Hb Barts (gamma4), hydrops fetalis
3 allele a thalassemisa
HbH disease, excess b globin— froms b4 (mild to moderate anemia, HSM, yellowing skin)
b thal minor
asymptomatic, HbA2 >3.5%
b thal major
severe anemia, skeletal deform, HSM
Enzymes inhibited by lead poisoning
ferrochelatase, ALA dehydratase
Signs of Lead poisioning (4)
LEAD: Lead lines on gingivae, metaphyses Encephalopathy and Erythrocyte basophilic stippling Abdominal cloic and sideroblastic Anemia Drops= wrist and foot
Treatments of lead poisioning
Succimer for chelation for kids
EDTA/ Dimercaprol
Genetic cause sideroblastic anemia
X-linked g-ALA synthase gene
treatment of sideroblastic anemia
pyridoxine (B6)
Nonhemolytic Normocytic anemia (4)
ACD, Aplastic anemia, chronic kidney disease, iron deficiency
Megaloblastic Macrocytic anemia (3)
Folate deficiency, B12 deficiency, Orotic aciduria
Homocystiene/ Methylmalonic acid in Folate vs B12 deficiency
Folate: incr homocysteine, normal methylmalonic acid
B12: incr homocysteine, incr methylmalonic acid
Sx of Folate deficiency
hypersegmented neutrophils, glossitis
Sx B12 deficiency
hyperseg neutrophils, glossitis, Peripheral neuropathy (Sensorimotor), dorsal column (vibration/proprioception, lateral corticospinal (spasticity), dementia
Orotic aciduria presentation
megaloblastic anemia, not cured by folate or B12
Defect in orotic aciduria
UMP synthase (conversion of orotic acid to UMP- de novo pyrimidine synthesis)
Treatment of orotic aciduria
Uridine monophosphate
Nonmegaloblastic macrocytic anemia: causes
liver disease, alcoholism, reticulocytosis
Nonmegaloblastic macrocytic anemia: drugs
5-FU, zidovudine, hydroxyurea
Findings in intravascular hemolysis
decr haptoglobin, incr LDH, schistocytes, incr reticulocytes, urobilinogen in urine
Findings in extravascular hemolysis
spherocytes, incr LDH, incr unconj bilirubin (jaundice)
Mediator of ACD
hepcidin- released by liver
Drugs causing aplastic anemia
benzene, chloramphenicol, alkylating agents, antimetabolites, busulfan, vinblastine
Viral agents causing aplastic anemia
parvovirus, EBC, HIV, HCV
Intrinsic hemolytic normocytic anemia (5)
Hereditary spherocytosis, G6PD, pyruvate kinase, HbC/HbS defect, paroxysmal nocturnal hemoglobinuria
Defect in hereditary spherocytosis
ankyrin, band 3, protein 4.2, spectrin (structural)
Tests for hereditary spherocytosis
osmotic fragility test, eosin-5- maleimide binding test
Mediators of G6PD disease
decr glutathione, susceptibility to oxidant stress
Excacerbated by sulfa drugs, antimalarials, infection, fava beans
G6PD deficiency
Presentation of pyruvate kinase deficiency
hemolytic anemia in newborn
Defect in HbC
glutamic acid to lysine mutation
Defect in HbS
glutamic acid to valine mutation
Defective surface marker in PNH
CD55/CD59
Triad of PNH
coombs neg hemolytic anemia, pancytopenia, venous thrombosis
treatment of PNH
eculizmab
Extrinisic hemolytic normocytic anemia (4)
autoimmune, microangiopathic, macroangiopathic, infections
SLE assoc with __AIHA
warm
CLL assoc with __AIHA
warm and cold
M. pneumo assoc with ___AIHA
cold
infections mononucleosis assoc with ___AIHA
cold
amethyldopa assoc with___AIHA
warm
Affected enzyme in Acute intermittent porphyria
porphobilinogen deaminase
Symptoms of Acute inermittent porphyria
5 Ps (painful abdomen, port-wine colored urine, polyneuropathy, psych, preciptated by drugs, EtOH, starvation)
treatment of Acute intermittent porphyria
glucose, heme
porphyria cutanea tarda enzyme deficiency
uropporhyrinogen decarboxylase
porphyria cutanea tarda presetnation
blistering cutaneous photosensitivty
PT tests
common and extrinsic pathway
PTT tests
common and intrinsic pathway
Defect in Bernard Soulier
Gp1b
Defect in Glansmann thrombasthenia
GpIIb/IIIa
Antibodies in immune throbocytopenia
anti-Gpiib/IIIa
Inhibited in thrombotic thrombocytopenia purpura
ADAMTS13
Inheritance of vonWil dis
Autosomal dom
Treatment of vonwil dis
DDAVP
causes of antithrombin defiency
inherited or renal failure/nephrotic syndrome
Factors inactivated by Prot C and S
V and VIII
multiple, peripheral nodes; extranodal inolvement common
NHL
Age distribution H vs NHL
H: bimodal: young adult, >55
NHL: 20-40
Most common form NHL
nodular sclerosing
Worst prognosis NHL
lymphcyte mixed or depleted
Markers of Reed-sternberg cell
CD15, CD30 (2 owl eyesx15=30)
2 presentations of Burkitt lymphoma
African: jaw lesion, endemic
pelvis or abdominal mass: sporadic
t(8;14) translocation
Burkitt lymphoma, cymc/heavy-chain Ig
“starry sky” appearance lymphoma
Burkitt lymphoma
t(14;18) translocation
DLBL, follicular lymphoma, heavy chain Ig/bcl-2
t(11;14) translocation
Mantle cell lymphoma; cyclin 1D/ heavy chain Ig
presentation Adult T cell lymphoma
lytic bone lsesion, hypercalcemia, cutaneous lesions; HTLV-1 infection
Assoc with rouleau formation
multiple myeloma
Assoc with Bence jones proteins
multiple myleoma
Psuedo-Pelger-Huet anomoly: description/cause
neutrophil with bilobed nuclei/after chemotherapy
Age range ALL vs CLL
ALL: 60y
markers for ALL
TdT+, CD10+ (pre-B cell only)
Assoc with smudge cells
CLL
t(12:21) transolcation
better prognosis for ALL
Assoc with TRAP+ staining
Hairy cell leukemia
Treatment for hairy cell leukemia
cladribine (adenosine analog)
Treatment for M3 AML
all-trans retinoic acid
complication of treatment of M3 AML
DIC, release of Auer rods
Auer rods assoc with
M3 AML
t(15;17) translocation assoc with
M3 AML
t(9;22) translocation
philadelphia chromosome, CLL, treat with imatinib
Expressed by Langher hans cell histiocytosis
S-100, CD1a
Assoc with Birbeck granules
Langherhans cell histiocytosis
Mutation associated with CML disorders
JAK2
Erythromylagia (describe, disease assoc with)
Polycythemia vera; sever, burning pain and reddish or bluish discoloration
Bone marrow finding for essential thrombocytoisis
enlarged megakaryocytes
Causes of ectopic EPO production (5)
Renal cell carcinoma, Wilms tumor, cyst, hepatocellular carcinoma, hydronephrosis