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PANCE Prep > Heme > Flashcards

Heme Flashcards

1
Q

Rouleaux Formation

A

RBCs stick together like “stack of coins” due to increase plasma proteins

Disease: Multiple Myeloma

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2
Q

Auto Agglutination

A

Clumping of RBCs due to IgM auto-antibodies coating the surface of RBCs

Diseases: Cold agglutinin autoimmune hemolytic anemia

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3
Q

Howell-Jolly Bodies

A

Small dense basophilic RBC inclusions (usually removed by the spleen)

Diseases:

  • Decreased splenic function: autosplenectomy (ie sickle cell disease)
  • Severe hemolytic anemia, megaloblastic anemia
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4
Q

Hemolytic Cells

A

Bite Cells: bite-like deformity due to phagocyte removal of denatured Hgb
-Thalassemia, G6PD deficiency

Schistocytes: Fragmented RBCs
-Hemolytic anemia

Keratocytes: Helmet shaped RBCs; mechanical RBC damage in small vessels

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5
Q

Basophilic stippling

A

-Coarse blue granules in RBCs evenly distributed throughout the RBC

Diseases: Sideroblastic anemia; Thalassemias

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6
Q

Echinocytes

“Burr Cells”

A

RBCs w/ numerous, small, evenly spaced projections due to abnormal cell membrane

Disease: Uremia

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7
Q

Acanthocytes

“Spur Cells”

A

Few large spiny, irregular projections on the RBC membrane

Diseases: Liver dz, post splenectomy, thalassemia, autoimmune hemolytic anemia, renal dz

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8
Q

Target Cells (Condocytes)

A

HYPOchromic RBC w/ round area of central pigment “target-shaped”

Diseases:

  • Sickle Cell
  • Thalassemia
  • Severe Fe deficiency
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9
Q

Hypersegmented neutrophils

A

Neutrophils w/ >5 lobes

Diseases: B12 & Folate deficiencies

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10
Q

Auer Rods

A

Acute Myelogenous Leukemia (AML)

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11
Q

Reed-Sternberg Cells

A

Hodgkin Lymphoma

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12
Q

MCC of anemia worldwide

A

Iron deficiency anemia

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13
Q

MCC of iron deficiency anemia in the US

A

Chronic blood loss

  • excessive menstruation
  • occult GI bleed (colon cancer)
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14
Q

MCC of iron deficiency anemia worldwide

A

Decreased absorption

-Diet

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15
Q

Iron deficiency anemia patho

A

Decreased RBC production due to lack of iron & decreased iron stores (decreased ferritin)

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16
Q

Iron deficiency anemia clinical manifestations

A
  • fatigue, weakness, dyspnea, irritability, anorexia
  • Pagophagia: craving for ice
  • Pica: appetite for non-food substance

PE: koilonychia, angular cheilitis, tachycardia, glossitis, pallor

17
Q

Iron deficiency anemia lab findings

A
  • Microcytic Hypochromic anemia classic
  • Increased RDW
  • DECREASED ferritin, INCREASED TIBC, decreased transferrin saturation
18
Q

Iron deficiency anemia management

A

Iron replacement w/ Ferrous sulfate

19
Q

How to increase iron absorption

A

Take iron replacement w/ Vitamin C (ascorbic acid) w/ water or orange juice on an empty stomach

20
Q

Clinical manifestations of lead poisoning

A

Ataxia, fatigue, learning disabilities, difficulty concentrating, peripheral neuropathy (wrist or foot drop)

Intermittent abdominal pain, vomiting, loss of appetite, constipation

21
Q

Lead poisoning diagnosis/ lab values

A

Serum lead levels >10 mcg/dL

Peripheral smear: microcytic hypochromic anemia w/ basophilic stippling.
Ringed sideroblasts in the bone marrow

“Lead lines” on x-rays

22
Q

Lead poisoning management

A

Removal of source of lead

Succimer first-line as inpatient (oral chelation)

23
Q

Idiopathic bone marrow failure

A

Aplastic anemia

24
Q

Aplastic anemia classically caused by what toxin?

A

Benzene

25
Q

Pancytopenia w/ bone marrow hypocellularity

A

Aplastic anemia

26
Q

Clinical manifestations aplastic anemia/ pancytopenia

A

Easy bruising, bleeding, frequent infections, fatigue

-Thrombocytopenia: mucocutaneous bleeding

27
Q

Most accurate test for aplastic anemia/ pancytopenia

A

Bone marrow biopsy
-hypocellular, fatty bone marrow

Diagnosis of exclusion if bone marrow biopsy failure

28
Q

Initial treatment of choice for aplastic anemia/ pancytopenia

A

Supportive management

29
Q

Treatment of choice for sever aplastic anemia/ pancytopenia in otherwise healthy pt <50 yrs

A

Allogenic hematopoietic stem call transplantation

30
Q

X-linked recessive disorder common in African American males

A

G6PD deficiency

31
Q

In G6PD deficiency, denatured hemoglobin precipitated as ____

A

Heinz bodies

32
Q

Exacerbating factors for G6PD deficiency

A
  • Infections (MCC)
  • Fava beans
  • Medications: oxidative drugs (dapsone, primaquine, nitrofurantoin)
33
Q

Peripheral smear diagnosis for G6PD

A

Normocytic hemolytic anemia during crisis

  • schistocytes (bite or fragmented cells)
  • Heinz bodies hallmark
34
Q

Causes of Hemolytic anemia

A
  • G6PD deficiency
  • Sickle cell disease
  • TTP
  • HUS
  • DIC
35
Q

Lab findings hemolytic anemia

A
  • INCREASED reticulocyte count
  • INCREASED unconjugated (indirect) bilirubin
  • DECREASED haptoglobin
  • INCREASED LDH

PANCE Prep (3 decks)

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