Heme Flashcards
Meds that Cause Agranulocytosis
Clozapine
Colchicine
Carbamazepine
Dapsone
PTU
Ticlopidine
CCCDPT
Lead Poisoning Inhibits….
ferrochelatase and ALA dehydratase
Acute Intermittent Porphyria
Symptoms
5 P’s
- pain in abdomen
- polyneuropathy
- psychological abnormalities
- pink/purple urine
- precipitated by drugs
Porphyria Cutanea Tarda Symptoms
- Tea colored urine (dark due to porphyrinogen in urine)
- Photosensitivity
Microcytic Anemia with LOW ferritin
Iron deficiency anemia
Microcytic Anemia with NORMAL ferritin
FAST
F (ferritin)
Anemia of Chronic Disease
Sideroblastic Anemia
Thalassemia
Vit. B12 deficiency
____ Homocysteine
_____ MMA
Increased Homocysteine
Increased MMA
Folate deficiency
____ Homocysteine
_____ MMA
Increased Homocysteine
No change in MMA
Increased Reticulocytes … what time of anemia?
Hemolytic Anemia
Decrease Reticulocytes … marker of function for ___ ____ failure.
bone marrow
Lead Poisoning is what type of anemia?
Sideroblastic Anemia
Common Symptoms of Lead Poisoning
- Blue Lead Lines
- Developmental Delay in children
(Q will say something about old house or child eating paint)
Beta Thalassemia Major Symptoms
- Chipmunk facies
- Marked Hepatomegaly
- Severe Anemia
- BM expansion (crew cut appearance on x-ry)
Beta Thalassemia Treatment Options
- Transfusions
- Deferoxamine (iron chelator)
- Hydroxyurea (increased HbF)
Beta Thalassemia Hb Types
HbA2 and HbF (no HbA)
Sickle Cell Anemia (AA substitution)
- glutamine to valine
Most common cause of Osteomyelitis in people with Sickle Cell?
- Salmonella
- Staph Aureus
Sickle Cell Crisis Treatment (Acute Chest Syndrome)
- Oxygen
- Hydration
- Hydroxyurea (increase HbF)
- manage pain
Myelofibrosis RBC Shape
tear drop cells
Prednisone can cause what type of Anemia?
Hemolytic Anemia
- Increases Rct count
- Decreased Haptoglobin
- Increased LDH and bilirubin
Hereditary Spherocytosis Defects
spectrin/ankyrin
- Small, round RBC’s with NO central pallor
Hereditary Spherocytosis Definitive Diagnostic Test
+ Osmotive Fragility
Treatment from Hereditary Spherocytosis
- Splenectomy
- can also give folic acid to prevent aplastic anemia development
PNH Mutation
PIG-A gene
PNH uses GPI for __ and __ anchoring
CD55 and CD59
PNH lacks __ and __ on flow cytometry
CD55 and CD59
G6PD Hemolysis has decreased ____.
NADPH
- low NADPH; inability to maintain glutathione in a reduced state
G6PD Inheritance Pattern
X-linked recessive
G6PD can be exhasterbated by…
- oxidative stress (fava beans)
- Meds (primaquine, dapsone, bactrim)
Increase ___ = Increased viscosity
HCT
Increases HCT/Viscosity in…
- polycythemia vera
- hereditary spherocytosis
- multiple myeloma
Name this Disorder
- Increase HCT
- Normal RBC mass
Relative (stress) Erythrocytosis
- most commonly due to dehydration
Name this Disorder
- Increase HCT
- Increase RBC mass
- Increase WBC
- Increase Platelents
- Polycythemia Vera (JAK-STAT mutation)
or - Chronic Hypoxia (COPD)
- Renal tunors
Athletes can get Erythrocytosis by…
anabolic steroids
Name this type of Hemolytic Anemia
- extensive bleeds
- coag cascade activated
- PT and PTT prolonged; low fibrinogen
- increased fibrin and degradation products
DIC
degradation products = d-dimer
Name this type of Hemolytic Anemia
- fever + neurologic + thrombocytopenia
- NO bleeding
- O157:H7 Shigella toxin
Hemolytic Uremic Syndrome
Name this type of Hemolytic Anemia
- fever + neurologic + thrombocytopenia
- isolated activation of platelets
-normal PT and aPTT
TTP
____ skin necrosis - patients with protein __ and __ deficiency
Warfarin
- protein C and S deficiency
Vit. K deficiency = decreased __ ______
gamma carboxylation
2 Vitamins babys are low in in?
- Vit. K and Vit. D
Use a ristocetin assay to test for….
vWF deficiency
Name this Disease
- normal PT
- Prolonged PTT
- Increased Bleeding Time
- most common hereditary blood disorder
vWF deficiency
vWF binds to ___ on endothelium in order to mediate ____ adhesion.
- binds to COLLAGEN
- mediates PLATELET adhesion
What drug activates antithrombin III?
Heparin
Name the Drug
- acetylates and irreversibly inhibits cyclooxygenase (COX-1 and COX-2)
- increases bleeding time
Aspirin
Name the Drug
- inhibits platelet aggregation by irreversibly blocking ADP receptors
clopidogrel and ticlopidine
Name the drug
- monoclonal antibody that bind to the glycoprotein receptor IIb/IIIa on activated platelets; prevents platelet aggregation
Abciximab
