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hematology pp clues Flashcards

1
Q

What is a Neutrophil? Function

A

The Phagocyte (has anti-microbials, most abundant)

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2
Q

What is an Eosinophil?

A

The Parasite Destroyer, Allergy Inducer

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3
Q

What is a Basophil?

A

The Allergy Helper (IgE receptor => histamine release)

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4
Q

What is a Monocyte?

A

The Destroyer => MP (hydrolytic enzymes, coffee-bean nucleus)

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5
Q

What is a Lymphocyte?

A

The Warrior => T, B, NK cells

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6
Q

What is a Platelet?

A

The Clotter (no nuclei, smallest cells)

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7
Q

What is a Blast?

A

Baby Hematopoietic cell

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8
Q

What is a Band?

A

Baby Neutrophil

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9
Q

What does high WBC and high PMNs tell you?

A

Stress demargination

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10
Q

What does high WBC and <5% blasts tell you?

A

Leukemoid reaction, seen in burn pts (extreme demargination looks like leukemia)

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11
Q

What does high WBC and >5% blasts tell you?

A

Leukemia

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12
Q

What does high WBC and bands tell you?

A

Left shift => have infection

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13
Q

What does high WBC and B cells tell you?

A

Bacterial infection

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14
Q

What diseases have high eosinophils?

A

“NAACP”
Neoplasm (lymphoma)
Allergy/ Asthma
Addison’s disease (no cortisol → relative eosinophilia)
Collagen vascular disease Parasites

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15
Q

What diseases have high monocytes (>15%)?

A

“STELS”
Syphilis: chancre, rash, warts
TB: hemoptysis, night sweats
EBV: teenager sick for a month
Listeria: baby who is sick
Salmonella: food

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16
Q

What do high retics (>1%) tell you?

A

RBC being destroyed peripherally

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17
Q

What do low retics tell you?

A

Bone marrow not working right (↓production)

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18
Q

What is Poikilocytosis?

A

Different shapes

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19
Q

What is Anisocytosis?

A

Different sizes
Either treating or healing from anemia

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20
Q

What is the RBC lifespan?

A

120 days

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21
Q

What is the platelet lifespan?

A

7 days

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22
Q

What does –penia tell you?

A

Low levels (usually due to virus or drugs)

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23
Q

What does –cytosis tell you?

A

High levels

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24
Q

What does –cythemia tell you?

A

High levels

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25
Q

What is the difference between plasma and serum?

A

Plasma: no RBC
Serum: no RBC or fibrinogen

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26
Q

What is Chronic Granulomatous Disease?

A

NADPH oxidase deficiency → recurrent Staph/Aspergillus infections (Nitroblue Tetrazolium stain negative)

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27
Q

What does Myeloperoxidase deficiency cause?

A

Catalase + infections

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28
Q

What is Chediak Higashi? Can you say that real fast 3 times in a row?…

A

Lazy leukocyte syndrome: lysosomes are slow to fuse around bacteria

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29
Q

What organ can make RBCs if the long bones are damaged?

A

Spleen => splenomegaly

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30
Q

What causes a shift to the right in the Hb curve?

A

“All CADETs face right”*
* ↑CO2
* Acid/Altitude * 2,3-DPG
* Exercise
* Temp

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31
Q

How does CO poison Hb?

A

Competitive inhibitor of O2 on Hb => cherry-red lips, pinkish skin hue

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32
Q

How does Cyanide poison Hb?

A

Non-competitive inhibitor of O2 on Hb => almond breath

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33
Q

What is MetHb?

A

Hb w/ Fe3+

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34
Q

What is Acute Intermittent Porphyria?

A

↑Porphyrin, urine δ-ALA, porphobilinogen => abdominal pain, neuropathy, red urine

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35
Q

What is Porphyria Cutanea Tarda?

A

Sunlight => skin blisters w/
porphyrin deposits, Wood’s

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36
Q

What is Erythrocytic Protoporphyria?

A

Porphyria cutanea tarda in a baby

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37
Q

What is Sickle cell disease?

A

Homozygous HbS: (βGlu6 →Val) => vaso- occlusion, necrosis, dactylitis (painful fingers/toes) at 6mo, protects against malaria

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38
Q

What is Sickle cell trait?

A

Heterozygous HbS => painless hematuria, sickle with extreme hypoxia (can’t be a pilot, fireman, diver)

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39
Q

What is Hb C disease?

A

(βGlu6→Lys), still charged =>no sickling

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40
Q

What is α-thalassemia?

A

1 deletion: Normal
2 deletions “trait”: Microcytic anemia
3 deletions: Hemolytic anemia, Hb H=β4
4 deletions: Hydrops fetalis, Hb Bart=γ4

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41
Q

What is β-thalassemia?

A

1 deletion “β minor”: HbA2 and HbF
2 deletions “trait/intermedia/major”:
only HbA2 and HbF => hypoxia at 6 mo

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42
Q

What is Cooley’s anemia?

A

See w/ β thalassemia major (no HbA => excess RBC production); baby making blood from everywhere => frontal bossing, hepatosplenomegaly, long extremities

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43
Q

What is Virchow’s triad?

A

Thrombosis risk factors:
1) Turbulent blood flow “slow”
2) Hypercoaguable “sticky”
3) Vessel wall damage “escapes”

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44
Q

What does acute hypoxia cause?

A

Shortness of breath

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45
Q

What does chronic hypoxia cause?

A

Clubbing of fingers/toes

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46
Q

What is intravascular hemolysis?

A

RBC destroyed in blood vv. → low haptoglobin (binds free floating

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47
Q

What is extravascular hemolysis?

A

RBC destroyed in spleen (problem w/ RBC membrane)=>splenomegaly

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48
Q

What enzymes need lead (Pb)?

A
  • δ-ALA dehydratase
  • Ferrochelatase
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49
Q

What does EDTA bind?

A

X2+

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50
Q

What disease has a smooth philthrum?

A

Fetal alcohol syndrome

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51
Q

What disease has a long philthrum?

A

William’s

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52
Q

What disease has sausage digits?

A

Pseudo-hypoparathyroidism, psoriatic arthritis

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53
Q

What disease has 6 fingers?

A

Trisomy 13

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54
Q

What disease has 2-jointed thumbs?

A

Edwards and Diamond-Blackfan

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55
Q

What disease has painful fingers?

A

Sickle cell disease

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56
Q

What are the Microcytic Hypochromic anemias? “FAST Lead”
* Fe deficiency
* Anemia of chronic disease
* Sideroblastic anemia
* α-Thalassemia
* β-Thalassemia
* Pb poisoning

A

↑TIBC, menses, GI bleed, koilonychia
↓TIBC
↓δ-ALA synthase, blood transfusions AA,
Asians (Chr.16 deletion)
Mediterraneans (Chr.11 point mutation)
↓δ-ALA dehydratase,
↓ferrochelatase,
x- ray blue line, eating old paint chips

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57
Q

What are the Megaloblastic anemias?

A
  • Vit B12 deficiency
  • Folate deficiency
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58
Q

MCC Vit B12 deficiency

A

Tapeworms, vegans, type A gastritis, pernicious anemia

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59
Q
  • Folate deficiency
A

overcooked food
glossitis

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60
Q

Alcohol

A

Fetal alcohol syndrome: smooth philthrum, stuff doesn’t grow

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61
Q

What are the Intravascular Hemolytic anemias?

A

IgM

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62
Q
  • G-6PD deficiency
A

Sulfa drugs, moth balls, fava beans, sudden drop in Hb

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63
Q
  • Cold autoimmune
A

Mononucleosis, mycoplasma infections, RBC agglutination

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64
Q

What are the Extravascular Hemolytic anemias?

65
Q

Spherocytosis

A

Defective spherin or ankyrin, + osmotic fragility test

66
Q
  • Warm autoimmune
A

Anti-Rh Ab, dapsone, PTU, anti- malarials, sulfa drugs

67
Q
  • Paroxysmal cold autoimmune
A

Bleeds after cold exposure, Donath- Landsteiner Ab

68
Q
  • Sickle cell anemia
A

Crew haircut x-ray, avascular necrosis of femur, painful toes and fingers

69
Q

What are the Production Anemias?

A
  • Diamond-Blackfan: No RBCs, 2-jointed thumbs
  • Aplastic anemia: Pancytopenia, autoimmune, benzene, AZT, CAM, radiation
70
Q
  • Aplastic anemia:
A

Pancytopenia, autoimmune, benzene, AZT, CAM, radiation

71
Q

What is Basophilic Stippling?

A

Lots of immature cells, ↑mRNA
(Pb poisoning)

72
Q

What is a Bite cell = Basket cell?

A

Unstable Hb inclusions (G6-PD deficiency)

73
Q

What is a Burr cell = Echinocyte?

A

Pyruvate kinase deficiency, Liver dz,
Post- splenectomy

74
Q

What is Cabot’s ring body?

A

Vit B12 deficiency, Pb poisoning

75
Q

What is a Doehle body?

A

PMN leukocytosis (infection,
steroids, tumor)

76
Q

What is a Drepanocyte?

A

Sickle cell anemia

77
Q

What is a Helmet cell?

A

Fragmented RBC (Hemolysis: DIC,
HUS, TTP)

78
Q

What is a Heinz body?

A

Hb precipitates and sticks to cell membranes (G-6PD

79
Q

What is a Howell-Jolly body?

A

Spleen or bone marrow should have removed nuclei fragments (hemolytic anemia, spleen trauma, cancer)

80
Q

What is a Pappenheimer body?

A

Fe ppt inside cell (sideroblastic anemia)

81
Q

What is a Pencil cell = Cigar cell?

A

Fe deficiency anemia

82
Q

What is Rouleaux formation?

A

Multiple myeloma

83
Q

What is a Schistocyte?

A

Broken RBC (DIC, artificial heart valves)

84
Q

What is a Sideroblast?

A

Macrophages pregnant w/Fe (genetic
or multiple transfusions)

85
Q

What is a Spherocyte?

86
Q

What is a Spur cell = Acanthocyte?

A

Lipid high in serum

87
Q

What is a Stomatocyte?

88
Q

What is a Target cell = Codocyte?

A

Less Hb (Thallasemias or Fe deficiency)

89
Q

What is a Tear drop cell = Dacrocyte?

A

RBCs squeezed out of marrow (hemolytic anemia,bonemarrow

90
Q

What is the Clotting Cascade?

A

How you stop bleeding

91
Q

What are the Vitamin K clotting factors?

A

1 (0) 927
Protein C and Protein S

92
Q

What do platelet problems cause?

A

Bleeding from skin and mucosa

93
Q

What do clotting factor problems cause?

A

Bleeding into cavities

94
Q

What causes increased PTT and bleeding time?

A

von Willebrand disease and Lupus

95
Q

What is Bernard-Soulier?

A

Baby w/ bleeding from skin and mucosa, big platelets (low GP1b)

96
Q

What is Glanzmann’s?

A

baby w/ bleeding from skin and
mucosa (low GP2b3a)

97
Q

How does Factor 13 deficiency present?

A

Umbilical stump bleeding (1st time baby has to stabilize a clot)

98
Q

What is Factor V Leiden?

A

Protein C can’t break down Factor 5
=> more clots

99
Q

How does von Willebrand Disease present?

A

Heavy menstrual bleeding

100
Q

What are the types of VWD?

A

Type 1 (AD): ↓VWF production
Type 2 (AD): ↓VWF activity (+ Ristocetin aggregation test)
Type 3 (AR): No VWF

101
Q

What is Hemophilia A?

A

Defective Factor 8 (< 40% activity) => bleed into cavities (head, abdomen, etc.)

102
Q

What is Hemophilia B?

A

Factor 9 deficiency => bleed into joints (knee, etc.)

103
Q

What diseases have low LAP?

104
Q

What has high LAP?

A

Leukemoid reaction

105
Q

What is the difference between acute and chronic leukemias?

A

Acute: started in bone marrow, squeezes RBC out of marrow Chronic: started in periphery, not constrained => will expand

106
Q

What is the difference between myeloid and lymphoid leukemias?

A

Myeloid: ↑RBC, WBC, platelets, MP (↓lymphoid cells) => bone marrow biopsy Lymphoid: ↑NK, T, B cells (↓myeloid cells) => do lymph node

107
Q

What defines ALL?

A

<15y/o males, bone pain, PAS stain
+, TdT +

108
Q

What defines AML?

A

15-30y/o males, Sudan Stain, Auer rods

109
Q

What defines CML?

A

30-50y/o females, t(9,22) “Philadelphia chromosome”, bcr-abl, ↓LAP

110
Q

What defines CLL?

A

> 50 y/o males w/ lymphadenopathy, “soccer ball” nuclei, smudge cells

111
Q

What defines Hodgkin’s lymphoma?

A

EBV, may have Reed-Sternberg cells

112
Q

What are the B cell Non- Hodgkin’s lymphomas?

A

Follicular: t(14,18), bcl-2
Burkitt: t(8,14), c-myc, starry sky MP
* American kids: abdominal mass
* African kids: jaw mass

113
Q

What are the T cell Non- Hodgkin’s lymphomas?

A

Mycosis fungoides: total body rash
Sezary syndrome: cerebriform

114
Q

What is Polycythemia Vera?

A

Hct >60%, ↓Epo, Budd-Chiari,
plethoric “pruritis after bathing”

115
Q

What is Essential Thrombocythemia?

A

Very high platelets, stainable Fe, ↓c-mpl

116
Q

What is Myelofibrosis?

A

Megakaryocytes, fibrotic marrow => teardrop cells, extramedular hematopoiesis

117
Q

What are plasma cytomas?

A

Produce lots of Ab

118
Q

What is Waldenstrom Macroglobulinemia?

A

IgM, hyperviscous

119
Q

What is Monoclonal Gammopathy of Undetermined Significance?

A

Old person w/ gamma spike

120
Q

What is Multiple Myeloma?

A

Serum M prot (IgG), urine Bence- Jones protein, rouleaux, punched-out lesions

121
Q

What is Heavy Chain Disease?

A

↑IgA, infiltration of bowel wall

122
Q

What is Histocytosis X?

A

Kid w/ eczema, skull lesions, diabetes insipidus, exopthalmos

123
Q

What does the Coombs test tell you?

A

Ab involved against RBC

124
Q

What does the direct Coombs test tell you?

A

On surface => hemolytic anemias

125
Q

What does the indirect Coombs test tell you?

126
Q

What is type and cross?

A

You know you can use that blood, save it for specific pt

127
Q

What is type and match?

A

Type it and wait

128
Q

What is forward typing?

A

Uses Ab to detect Ag “Fabulous”

129
Q

What is backward typing?

A

Uses Ag to detect Ab

130
Q

What does blood type A tell you?

A

Have the A antigen

131
Q

What does blood type O tell you?

A

Have no antigens, universal donor

132
Q

What does blood type AB tell you?

A

Have both antigens, universal recipient

133
Q

What does Rh + tell you?

A

Has D antigen

134
Q

What does Rh – tell you?

A

Does not have D antigen

135
Q

hemolytic disease of the newborn?

A

Rh – Mom’s placenta tears, 100cc baby’s blood sees Mom/produces Ab, attacks fetus

136
Q

What is RHOGAM?

A

Anti-D IgG

137
Q

When do you give RHOGAM?

A

1st Dose: after delivery of 1st baby
2nd Dose: week 28 of any subsequent pregnancy

138
Q

What is the most common transplant?

139
Q

What is a Syngenic transplant?

A

Twin to twin

140
Q

What is an Autograft?

A

Self-to-self transplant

141
Q

What is an Allograft?

A

Human-to-human transplant

142
Q

What is a Xenograft?

A

1 species to another species

143
Q

What is Hyperacute rejection?

A

Within 12 hrs (preformed Ab)

144
Q

What is Acute rejection?

A

4 days to years later (T-cells, MP)

145
Q

What is Chronic rejection?

A

> 7 days (Fibroblasts)

146
Q

What is Graft vs. Host disease?

A

Bone marrow transplants reject (TK, MP)

147
Q

What are Immunoprivileged sites?

A

No lymphatic flow => no Ag => easy to transplant (brain, cornea, thymus, testes)

148
Q

What is INR?

A

Measured PT/ Control PT

149
Q

Lymphoma:scanty cytoplasm n irregular, twisted, indented nuclei

A

T(18:14) follicular B-cell lymphoma
IGH locus (14) and BCL2(18)

150
Q

MCC of every ‘penia is

A

Viral infection
Drugs

151
Q

Migration through the endothelium is via

152
Q

CD-18
INTEGRIN are seen during

A

Pavementing

153
Q

Leukocytosis dt stress demargination WBC/NEUROPHILS

A

WBC up
Neutrophils up

154
Q

Leukocytosis dt infection: bands

A

Up
Left shift: kills germs

155
Q

Leukomoid reaction: blast level

A

Below 5%
Low T cell and eosinophils

156
Q

Leukemia blast level

157
Q

Cancer is more common in women b/t

158
Q

PAS (+), TDT, Calla pos

A

ALL
Calla mean good response to chemo

159
Q

AML LAB

A

Auer Rod
Sudan Black
T(15/17)

Step 1 Clues (27 decks)

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