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NPLEX 1 > Hematology + Oncology > Flashcards

Hematology + Oncology Flashcards

1
Q

Give the associated pathology for the pathologic RBC: Ancanthocyte

A

Liver disease, abetalipoproteinemia (states of cholesterol dysregulation)

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2
Q

What is the “common name” for ancanthocytes?

A

Spur cells

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3
Q

Give the associated pathology for the pathologic RBC: Basophilic stippling

A

Anemia of chronic disease, alcohol abuse, lead poisoning, thalassemias

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4
Q

Give the associated pathology for the pathologic RBC: Bite cell

A

G6PD deficiency

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5
Q

Give the associated pathology for the pathologic RBC: Elliptocyte

A

Hereditary elliptocytosis

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6
Q

Give the associated pathology for the pathologic RBC: Macro-ovalocyte

A

Megaloblastic anemia (also hyper segmented PMNs), marrow failure

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7
Q

Give the associated pathology for the pathologic RBC: Ringed sideroblast

A

Sideroblastic anemia. Excess iron in mitochondria = pathologic

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8
Q

Give the associated pathology for the pathologic RBC: schistocyte, helmet cell

A

DIC, TTP/HUS, traumatic hemolysis (i.e mechanical heart valve prosthesis)

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9
Q

Give the associated pathology for the pathologic RBC: sickle cell

A

Sickle cell anemia

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10
Q

Give the associated pathology for the pathologic RBC: Spherocyte

A

Hereditary spherocytosis, autoimmune hemolysis

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11
Q

Give the associated pathology for the pathologic RBC: teardrop cell

A

bone marrow infiltration (e.g., myelofibrosis)

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12
Q

Give the associated pathology for the pathologic RBC: Target cell

A

HbC disease, Asplenia, Liver disease, Thalassemia

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13
Q

Explain the pathological process associated with Heinz bodies

A

Oxidation of hemoglobin sulfhydryl groups –>denatured hemoglobin precipitation and phagocytic damage to RBC membrane –> bite cells.

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14
Q

How can we visualize Heinz bodies?

A

crystal violet stain

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15
Q

Explain the pathological process associated with Howell-Jolly bodies

A

Basophilic nuclear remnants found in the RBCs.

Howell-Jolly bodies are usually removed from RBCs by splenic macrophages

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16
Q

List some pathologies associated with a finding of Howell-Jolly bodies

A

Functional hyposplenia

Asplenia

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17
Q

List some pathologies associated with a finding of Heinz Bodies

A

See in G6PD deficiency

Heinz body like inclusions are seen in alpha-thalassemia

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18
Q

What MCV value is consistent with microcytic anemias?

A

<80 fL

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19
Q

What MCV value is consistent with normocytic anemia?

A

80-100 fL

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20
Q

What MCV value is consistent with macrocytic anemia?

A

> 100 fL

21
Q

How are normocytic anemias further divided?

A

normocytic anemias are either non-hemolytic or hemolytic

22
Q

What is the reticulocyte count like in non-hemolytic normocytic anemias?

A

normal or decreased

23
Q

What is the reticulocyte count like in hemolytic anemias?

A

increased

24
Q

What pathologies lead to microcytic anemia? List 5

A 
Iron Def (late)
ACD (anemia of chronic disease)
Thalassemias
Lead poisoning
Sideroblastic anemia
25
Q

What pathologies lead to non-hemolytic normocytic anemia? List 4

A

ACD (anemia of chronic disease)
Aplastic anemia
Chronic kidney disease
Iron def (early)

26
Q

How are normocytic hemolytic anemias categorized?

A

Into intrinsic/extrinsic variations

27
Q

List 5 pathologies that end in intrinsic hemolytic anemia.

A

RBC membrane defect: hereditary spherocytosis
RBC enzyme deficiency: G6PD, pyruvate kinase
HbC defect
Paroxysmal noctural hemoglobinuria
Sickle cell anemia

28
Q

List 4 pathologies that end in extrinsic hemolytic anemia.

A

Autoimmune disease
Microangiopathic
Macroangiopathic
Infections

29
Q

How are macrocytic anemias divided?

A

Into either magloblastic or non-megaloblastic

30
Q

List 3 pathologies that lead to megaloblastic macrocytic anemia.

A

Folate deficiency
B12 def
Orotic aciduria

31
Q

List 3 pathologies that lead to non-megaloblastic macrocytic anemia.

A

Liver disease
Alcoholism
Reticulocytosis

32
Q

What are the findings for microcytic, hypo chromic anemia secondary to iron deficiency?

A 
Decreased Iron
Increase total iron binding capacity
Decreased ferritin
fatigue
conjunctival pallor
May manifest as Plummer-Vinson syndrome
33
Q

Describe plummer-vinson syndrome

A

Triad of:
Iron Def
Esophageal webs
Atrophic glossitis

34
Q

What is alpha-thalassemia?

A

A defect leading to alpha-globin gene deletions that result in decreased alpha-globin syn

35
Q

Which deletions do you see in alpha-thalassemia for the asian vs. african american population?

A 
Cis = asian
Trans = African
36
Q

Describe findings associated with a 3 allele deletion in alpha-thalassemia

A

HbH disease.
Very little alpha-globulin
Excess B-globin forms B4 (HbH)

37
Q

Describe the findings associated with a 1-2 allele deletion in alpha-thalassemia

A

no clinically significant anemia

38
Q

Describe the findings associated with a 4 allele deletion in alpha-thalassemia

A

No alpha-globulin
Excess y-globulin forms Y4 (Hb Barts)
Incompatible with life (causes hydrous fetalis)

39
Q

Describe microcytic, hypochromic anemia secondary to B-thalassemia

A

Point mutation in splice sites and promoter sequences –> decreased B-globin synthesis.
(Prevalent in mediterranean populations)

40
Q

Describe the 3 findings associated with B-thalassemia minor (heterozygote)

A
  • B chain is under produced
  • usually asymptomatic
  • diagnosis confirmed by increased HbA2 (>3.5%) on eletrophoresis
41
Q

Describe the 3 findings associated with B-thalassemia major (homozygous)

A
  • B-chain is absent –> severe anemia requiring blood transfusion (secondary hemochomatosis)
  • marrow expansion –> skeletal deformaties. Chipmunk facies
  • Extramedullary hematopoiesis (leads to hepatosplenomegaly). Increased risk of parvovirus B19-induced aplastic crisis
42
Q

What significance does HbF play in infants?

A

HbF is protective in infants and disease doesn’t become symptomatic until 6 mo.

43
Q

How does lead cause poisoning?

A

Lead inhibits ferrochelatase and ALA dehydratase –> decreased heme synthesis and increased RBC protoporphyrin.
Also inhibits rRNA degredation, causing RBCs to retain aggregates of rRNA (basophilic stippling)

44
Q

List some signs of lead poisoning

A
  • lead lines in the gingivae (burton lines) and on metaphases of long bones
  • encephalopathy and erythrocyte basophilic stippling
  • abdominal colic and sideroblastic anemia
  • drops: wrist and foot
45
Q

What is sideroblastic anemia?

A

defect in heme synthesis

hereditary: x-linked in gamma-ALA synthase gene

46
Q

What findings are associated with sideroblastic anemia?

A

ringed sideroblasts (Fe+ laden mitochondria)
Increased Iron
Normal total iron binding capacity
increased ferritin

47
Q

List some causes of sideroblastic anemia.

A

Genetic
Acquired (myelodysplastic syndromes)
Reversible: alcohol, lead, vitamin B6 deficiency, copper deficiency, isoniazid

48
Q

restudy pages 384 onwards…

A

not making the rest of these freakin Q cards UGH!

NPLEX 1 (10 decks)

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