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Q1 > Heme > Flashcards

Heme Flashcards

1
Q

check serum levels of what (2) for B12 deficiency

A

inc homocystein & methylmalonic acid

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2
Q

where is vit b12 (cobalamin) stored

A

liver

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3
Q

increased demand of folate/b12

A

preg, cancer, hemolytic anemia, infancy

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4
Q

increased loss in folate def (2)

A

dialysis, skin disorders

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5
Q

what’s only seen in b12 def (vs folate def)

A

numbness/tingling/abnormal neurologic exam

methylmalonic acid builds up in myelin

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6
Q

which anemia doesn’t show hepatosplenomegaly

A

iron deficiency anemia

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7
Q

jaundice: what’s going on w/ RBCs?

A

hemolysis

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8
Q

s/s of acute vs chronic hemolysis

A

pallor, fatigue, jaundice

acute: fever, chills, headache
chronic: hepatosplenomegaly, gallstones

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9
Q

schistocytes

A

non-immune hemolytic anemia

def: fragmented cells

mechanical stress

  1. intravascular: fibrin
  2. extravascular: prosthetic valves
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10
Q

what receptor on the plt does vWF binds to

A

GP1b

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11
Q

vWF is derived from (2)

A
  1. plt: a-granules

2. endothelial cells: Wiebel-Palade bodies

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12
Q

4 steps of Primary Homeostatis

A
  1. transient vasoconstriction (reflexive neural stimulation, endothelin from endo cells)
  2. plt adhesion to surface of disrupted vessel’s (plt’s GP1b-vWF)
  3. plt degranulation (ADP-> expose GP2b/3a, TXA2)
  4. plt aggregation (btw plt’s GP2b/3a–fibrinogen linker molecule)
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13
Q

site of production: EPO vs TPO (thrombopoietin)

A

EPO: renal
TPO: liver

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14
Q

activation of cag cascade requires (3)

A
  1. exposure to activating substance
    - extrinsic: tissue thromboplastin -(activates)-> factor 7
    - intrinsic: subendothelial collagen -> factor 12
  2. phospholipid surface of plt
  3. Ca2+ (from plt dense granules, ADP is also in there )
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15
Q

defects in thrombin generation -> bleeding: except for which factor

A

Factor 12 defect: no effect in bleeding

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16
Q

Desmopressin

A

releases vWF from endothelial cells (but not from plts)

17
Q

vWF stabilizes/increases half-life/prevent degradation of which factor?

A

factor 8

18
Q

condition associated w/ low vWF

A

hypothyroidism, type O blood type

19
Q

acquired risk factors of DVT

A

antiphospholipid antibodies, etc.

20
Q

genetic risk factors of DVT

A

Thrombin inhibitors (Protein C/S, antithrombin), F5 Leiden, Prothrombin gene mutation, elevated F8?

21
Q

Factor V/5 Leiden

A

single mutation in F5 -> dysfunctional F5 -> “activated protein C resistance”
lab test: “Activated protein C resistance” assay, or genetic test

22
Q

What factors do Vitamin K activate?

A

Factors 2, 7, 9, 10, Protein C, S

23
Q

What enzyme does Vit K inhibit? what process is that enzyme involved in?

A

epoxide reductase in the liver activates Vit K

24
Q

things that can prolong PT (4)

A
  1. warfarin use
  2. DIC
  3. liver failure
  4. factor 5 or 10 deficiency
25
Q

M-component

A

a single homogeneous Ig product

26
Q

s/s of Plasma Cell Myeloma: POEMS

A

polyneuropathy, orgnomegaly, endocrine disturbances, M-protein, skin changes

27
Q

Eosinophilia in what kind of heme malignancy? which immune cytokine?

A

Hogdkin Lymphoma

IL-5

28
Q

basophilia associated w/ which leukemia

A

CML

29
Q

what’s only in lymphoblasts? in which malignancy?

A

TdT (DNA polymerase) in the nucleus

only in ALL

30
Q

what’s only in myeloblasts? in which malignancy?

A

MPO (myeloperoxidase) in cytoplasm

crystallizes as AUER RODS

31
Q

philadephila chromosome t(9;22) (longer vs shorter) indicated in which 2 malignancies

A

longer: CML
shorter: B-ALL (w/ poor prognosis) in adults

32
Q

2 malignancies that cause lytic bone lesion + hypercalcemia

A

multiple myeloma

ATLL (adult tcell leukemia/lymphoma)
= RASH + bone lesion

33
Q

Hairy Cell Leukemia (triad)

A

older men, splenomegaly, pancytopenia

Q1 (7 decks)

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