Heme Flashcards
PTT
intrinsic: 12, 11, 9, 8 (2), 10
PT
extrinsic: 7, 10
what does vWF carry?
factor 8
hemophilia A
factor 8 def
hemophilia B
factor 9 def
where do you see eosinophils?
NAACP (morpheus is in the NCAAP). Neoplasm, Asthma, Allergic, Collagen vascular disease, Parasites
Basophile granues contain
heparin, histamine, leukotrienes
warfarin mech
inhibits epoxide reductase to block vitamin k reduction. needed to make factor 2,7, 9, 10, C/S
vitamin enteric bacteria make for coagulation
vitamin k
factor 5 leiden
factor 5 is resistant to C/S (8 is still sensitive)
Heparin mechanism
activates antithrombin
antithrombin activity
inhibits activated form of factor 2, 7, 9, 10, 11, 12
vWF binds to ______ on endothelium
collagen
Plates binds to ______ on endothelium with ________
vWF, Gp1B
Plates release ______ after binding endothelium
ADP and Ca (ADP promotes coagulation)
Plates bind each other via
GpIIb/IIIa to fibrinogen
Glanzmann’s thrombasthenia
lack of GpIIb/IIIa
abciximab
blocks GpIIb/IIIa
Bernard-Soulier syndrome
lack of GpIb
Thrombomodulin
activates protein c/s
ERS increased in
infxn, immune activation, neoplasm, ulcerative colitis, pregnancy
ERS decreased in
polycythemia, sickle cell, CHF, microcytosis, hypofibrinogen (any perturb to blood componenets)
Acanthocyte
spiny cell. liver disease (cholesterol dysregulation)
basophilic stippling
thalassemia, anemia of chronic disease, lead poisoning
bite cell
G6PD def
schistocyte
RBC frag. DIC, TTP/HURS, mechanical destruction
target cell
microcytosis, HbC, Asplenia, thalassemia
Heinz bodies
G6DP, Thalassemia. oxidized iron precipates
Howel-Jolly bodies
nuclear remnants in RBCs seen in asplenia and mothball ingestion
Iron defiecency anemia findings
microcytosis, esophageal webs, low ferritin, high TBIC (weird)
alpha thalassemia
all 4 = fatal. 3 = HbH disease. Cis = asian. trans = african
beta thalassemia mech and population
splice site/promotoer mutations. in mediterranean populations
beta thalassemia minor vs major
minor is heterozygote and has little effect. major is severe and needs transfusions.
crew cut x-ray
ectopic blood production = severe thalassemia (beta major)
Lead poisoning molecular
inhibs ferrochelatase and ALA dehydratase (heme syn)
inhibits rRNA degradation -> basophilic stippling
Lead symptoms and treatment
MICROCYTIC: LEAD Sucks: Lead Lines on gingivae and long bones, Encephalopathy/Erythroyte basophilic stippling, Abdominal colic/sideroblastic Anemia, Drop wrist/foot
Treat with EDTA (1st line), Dimercaprol, SUCcimer
Sideroblastic anemia causes
MICROCYTIC: Hereditary: x-linked delta-ALA synthase
Reversible : alcohol, lead, isoiazid
Iron laden mitochondria
sideroblastic anemia
siderblastic anemia blood test for iron, TIBC, and ferritin. and treatment
high iron, normal TIBC, high ferritin. treat with pyridoxine B6 (cofactor for delta-ALA synthase)
megaloblastic anemia deficiencies and differences between them
folate def (normal mehtymalonic acid), B12 deficiency (high methylmalonic acid). cause both are needed to make dNTPs but only B12 used to convert methylmalonate-coA
features of macrocytic anemias
hypersegmented neutrophiles, macrocytosis, glossitis
sxm of B12 def
anemia, CNS degradation (particularly of the spinal tracts)
etiologies of folate deficency:
malnutrition, alcohol, malabsorption, antifolates (methotrexate, thrimethoprim, phenytoin) or higher need (pregnancy, hemolytic anemia)
etiologies of B12 defiencey
intake (vegans), malabsorb (crohns), pernicious anemia (intrinsic factor deficency) Diphyllobothrium latum (fish tapeworm), proton pump inhibitor
orotic aciduria anemia
megaloblastic anemia due to inability to convert orotic acid to uridine. treat with uridine monophosphate.
