Heme

Question 1

PTT

Answer 1

intrinsic: 12, 11, 9, 8 (2), 10

Question 2

PT

Answer 2

extrinsic: 7, 10

Question 3

what does vWF carry?

Answer 3

factor 8

Question 4

hemophilia A

Answer 4

factor 8 def

Question 5

hemophilia B

Answer 5

factor 9 def

Question 6

where do you see eosinophils?

Answer 6

NAACP (morpheus is in the NCAAP). Neoplasm, Asthma, Allergic, Collagen vascular disease, Parasites

Question 7

Basophile granues contain

Answer 7

heparin, histamine, leukotrienes

Question 8

warfarin mech

Answer 8

inhibits epoxide reductase to block vitamin k reduction. needed to make factor 2,7, 9, 10, C/S

Question 9

vitamin enteric bacteria make for coagulation

Answer 9

vitamin k

Question 10

factor 5 leiden

Answer 10

factor 5 is resistant to C/S (8 is still sensitive)

Question 11

Heparin mechanism

Answer 11

activates antithrombin

Question 12

antithrombin activity

Answer 12

inhibits activated form of factor 2, 7, 9, 10, 11, 12

Question 13

vWF binds to ______ on endothelium

Answer 13

collagen

Question 14

Plates binds to ______ on endothelium with ________

Answer 14

vWF, Gp1B

Question 15

Plates release ______ after binding endothelium

Answer 15

ADP and Ca (ADP promotes coagulation)

Question 16

Plates bind each other via

Answer 16

GpIIb/IIIa to fibrinogen

Question 17

Glanzmann’s thrombasthenia

Answer 17

lack of GpIIb/IIIa

Question 18

abciximab

Answer 18

blocks GpIIb/IIIa

Question 19

Bernard-Soulier syndrome

Answer 19

lack of GpIb

Question 20

Thrombomodulin

Answer 20

activates protein c/s

Question 21

ERS increased in

Answer 21

infxn, immune activation, neoplasm, ulcerative colitis, pregnancy

Question 22

ERS decreased in

Answer 22

polycythemia, sickle cell, CHF, microcytosis, hypofibrinogen (any perturb to blood componenets)

Question 23

Acanthocyte

Answer 23

spiny cell. liver disease (cholesterol dysregulation)

Question 24

basophilic stippling

Answer 24

thalassemia, anemia of chronic disease, lead poisoning

Question 25

bite cell

Answer 25

G6PD def

Question 26

schistocyte

Answer 26

RBC frag. DIC, TTP/HURS, mechanical destruction

Question 27

target cell

Answer 27

microcytosis, HbC, Asplenia, thalassemia

Question 28

Heinz bodies

Answer 28

G6DP, Thalassemia. oxidized iron precipates

Question 29

Howel-Jolly bodies

Answer 29

nuclear remnants in RBCs seen in asplenia and mothball ingestion

Question 30

Iron defiecency anemia findings

Answer 30

microcytosis, esophageal webs, low ferritin, high TBIC (weird)

Question 31

alpha thalassemia

Answer 31

all 4 = fatal. 3 = HbH disease. Cis = asian. trans = african

Question 32

beta thalassemia mech and population

Answer 32

splice site/promotoer mutations. in mediterranean populations

Question 33

beta thalassemia minor vs major

Answer 33

minor is heterozygote and has little effect. major is severe and needs transfusions.

Question 34

crew cut x-ray

Answer 34

ectopic blood production = severe thalassemia (beta major)

Question 35

Lead poisoning molecular

Answer 35

inhibs ferrochelatase and ALA dehydratase (heme syn) | inhibits rRNA degradation -> basophilic stippling

Question 36

Lead symptoms and treatment

Answer 36

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

Question 37

Sideroblastic anemia causes

Answer 37

MICROCYTIC: Hereditary: x-linked delta-ALA synthase | Reversible : alcohol, lead, isoiazid

Question 38

Iron laden mitochondria

Answer 38

sideroblastic anemia

Question 39

siderblastic anemia blood test for iron, TIBC, and ferritin. and treatment

Answer 39

high iron, normal TIBC, high ferritin. treat with pyridoxine B6 (cofactor for delta-ALA synthase)

Question 40

megaloblastic anemia deficiencies and differences between them

Answer 40

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

Question 41

features of macrocytic anemias

Answer 41

hypersegmented neutrophiles, macrocytosis, glossitis

Question 42

sxm of B12 def

Answer 42

anemia, CNS degradation (particularly of the spinal tracts)

Question 43

etiologies of folate deficency:

Answer 43

malnutrition, alcohol, malabsorption, antifolates (methotrexate, thrimethoprim, phenytoin) or higher need (pregnancy, hemolytic anemia)

Question 44

etiologies of B12 defiencey

Answer 44

intake (vegans), malabsorb (crohns), pernicious anemia (intrinsic factor deficency) Diphyllobothrium latum (fish tapeworm), proton pump inhibitor

Question 45

orotic aciduria anemia

Answer 45

megaloblastic anemia due to inability to convert orotic acid to uridine. treat with uridine monophosphate.