Heme First Aid

Question 1

WBC Differential

Answer 1

N L M E B

Question 2

increased immature neutrophils/band cells

Answer 2

increased myeloid production

• bacterial infection
• CML

Question 3

Causes of Eosinophilia

Answer 3

neoplastic
asthma
allergic processes
CVD
parasites

Question 4

B lymphocyte

Answer 4

humoral immune

bone marrow

Question 5

T lymphocyte

Answer 5

stem cells in bone marrow, matures in thymus

cellular immune response

Question 6

cytotoxic T cells

Answer 6

Cd8

recognized MHC I

Question 7

Helper T cells

Answer 7

express CD4

recognize MHC II

Question 8

Acanthocyte/spur cell

Answer 8

liver disease

abetalipoproteinemia

Question 9

Basophilic stippling

Answer 9

thalassemias
anemia of chronic disease
lead poisoning

Question 10

bite cell

Answer 10

G6PD def

Question 11

elliptocyte

Answer 11

hereditary elliptocytosis

Question 12

Macro-ovalocyte

Answer 12

megoblastic anemia

marrow failure

Question 13

ringed sideroblasts

Answer 13

sideroblastic anemia

excess iron in mitochondria

Question 14

schistocyte/helmet cell

Answer 14

DIC
TTP
HUS
traumatic hemolysis

Question 15

spherocyte

Answer 15

hereditary spherocytosis

autoimmune hemolysis

Question 16

tear drop cell

Answer 16

bone marrow infiltration (myelofibrosis)

Question 17

target cell

Answer 17

HbC disease
Asplenia
Liver disease
thalassemia

Question 18

Heinz body

Answer 18

G6PD def

heinz-body like inclusions with alpha thalassemia

Question 19

Howell-Jolly bodies

Answer 19

functional hyposplenia or asplenia

mothball ingestion/napthalene

Question 20

microcytic, hypochromic anemias

Answer 20

iron def
alpha thalassemia, beta thal
lead poisoning
sideroblastic

Question 21

macrocytic anemia

Answer 21

foltae, b12 def

nonmegaloblastic macrocytic anemias

Question 22

normocytic, normochromic anemias

Answer 22

intravascular, extravascular hemolysis
ACD
aplastic anemia
CKD

Question 23

intravascular hemolysis

Answer 23

increased LDH

hemoglobin in urine

Question 24

extravascular hemolysis

Answer 24

increase LDH plus increased UCB (jaundice!)

Question 25

Paroxysmal Nocturnal Hemoglobinuria symptoms

Answer 25

hemolytic anemia, pancytopenia, venous thrombosis

Question 26

PN Hemoglobinuria cause

Answer 26

increased complement mediated RBC lysis | loss of GPI linked proteins (CD 55/59)

Question 27

Labs for PN Hemoglobinuria

Answer 27

CD 55/ 59

Question 28

Treatment for PN Hemoglobinuria

Answer 28

eculizumab

Question 29

Hereditary Spherocytosis treatment

Answer 29

splenectomy

Question 30

Hereditary Spherocytosis Cause

Answer 30

red cell membrane instability | defect in ankyrin or spectrin

Question 31

G6PD exacerbated by

Answer 31

sulfa drugs infections fava beans

Question 32

G6PD genetics

Answer 32

X linked decreased glutathione Heinze bodies + bite cells

Question 33

Pyruvate kinase definency

Answer 33

hemolytic anemia in new born

Question 34

autosplenectomy

Answer 34

Howell-Jolly bodies | sickle cell

Question 35

Sickle Cell treatment

Answer 35

hydroxyurea (increases HbF) | BMT

Question 36

Warm agglutinin

Answer 36

IgG | often seen with SLE, CLL, alpha-methyldopa

Question 37

Cold Agglutinin

Answer 37

IgM | seen in CLL, mono, mycoplasma pneuomnia

Question 38

Microangiopathic anemia

Answer 38

schistocytes

Question 39

weird causes of microangiopathic anemia

Answer 39

malignant htn | sle

Question 40

Iron Def Labs

Answer 40

decreasd Iron increased TIBC/transferrin decreased ferritin decreased transferrin saturation (serum iron/TIBC)

Question 41

transferrin saturation

Answer 41

iron/TIBC

Question 42

Chronic disease labs

Answer 42

decreased iron decreased transferrin/TIBC increased ferritin

Question 43

Hemochromatosis labs

Answer 43

increased iron decreased transferrin increased ferritin increased transferrin saturation

Question 44

Pregnancy/OCP lab values

Answer 44

increased transferrin/TIBC | decreased transferrin saturation

Question 45

transferrin

Answer 45

transport iron in blood

Question 46

ferritin

Answer 46

primary iron storage protein

Question 47

Hemophilia A

Answer 47

``` def of VIII increase PTT ```

Question 48

Hemophilia B

Answer 48

``` def of IX increase PTT ```

Question 49

Vit K def

Answer 49

decrease synthesis of 2,7,9,10, protein C and S

Question 50

Hodgkin's Lymphoma

Answer 50

associated with EBV Reed-Sternberg Cells B signs/symptoms localized nodes

Question 51

Non-Hodgkin's Lymphoma

Answer 51

multiple, non contiguous nodes mostly involving B cells associations with HIV and immunnosuppresion

Question 52

Reed-Sternberg Cells

Answer 52

CD 30+, CD 15+ B cells

Question 53

plasma cells with clock face

Answer 53

Multiple Myeloma

Question 54

ALL

Answer 54

<15 years often mediastinal mass increased lymphoblasts

Question 55

Hair Cell Leukemia

Answer 55

B cell tumor in elderly | TRAP positive

Question 56

Hairy Cell Leukemia treatment

Answer 56

cladribine | adenosine analog

Question 57

AML

Answer 57

Auer rods older onset DIC common

Question 58

t(9:22)

Answer 58

CML philadelphia chromosome bcr-abl

Question 59

t(8:14)

Answer 59

Burkitt's lymphoma | c-myc activation

Question 60

t(11:14)

Answer 60

cyclin D1 activation | mantle cell lymphoma

Question 61

T(14:18)

Answer 61

follicular lymphomas | bcl-2 activation

Question 62

Polycytehmia vera

Answer 62

Jak2 mutation | increased, RBC, WBC, platelets

Question 63

JAK 2 mutation

Answer 63

polycytehmia vera

Question 64

deficient alpha-aminolevulinic acid

Answer 64

lead posioning

Question 65

symptoms of lead poisoning

Answer 65

mental deterioation, sideroblastic anemia

Question 66

anti-GpIIB/IIIa antibodies

Answer 66

ITP

Question 67

increased megakarocytes

Answer 67

ITP

Question 68

ADAMTS 13

Answer 68

vWF metalloprotease | TTP

Question 69

ITP, TPP lab values

Answer 69

increased BT | normal PT, PTT

Question 70

polycythemia symptoms

Answer 70

itching after shower (increased histamine) ruddy skin palpable spleen

Question 71

conseuqence of HIT

Answer 71

deep vein and arterial thrombosis

Question 72

Hereditary Angioedema

Answer 72

swelling of eyelids and lips | decrease C1 esterase inhibitor

Question 73

Heparin

Answer 73

anti-coagulant | cofactor for activation of anti-thrombin

Question 74

Warfarin

Answer 74

chronic anti-coag | interferes with synthesis and carboxylation of vit K dependent clotting factors

Question 75

Heparin monitoring

Answer 75

PTT (intrinsic)

Question 76

Warfarin monitoring

Answer 76

PT/INR (extrinsic)

Question 77

Warfarin overdose treatment

Answer 77

IV vitamin K and fresh frozen plasma

Question 78

ribavirin SE

Answer 78

hemolytic anemia

Question 79

Hodgkin's lymphoma treatment

Answer 79

Bleomycin

Question 80

Pacitaxel use

Answer 80

ovarian and breast carcinomas

Question 81

A blood Group

Answer 81

A antigen on RBC | anti-B antibody

Question 82

B blood Group

Answer 82

B antigen | anti-A antibody

Question 83

AB blood group

Answer 83

A, B antigens no antibodies universal recipient of RBC universal donor of plasma

Question 84

O blood group

Answer 84

Anti-A and Anti-B antibodies universial donor of RBCs universal recipient of plasma

Question 85

HbH

Answer 85

deletion of three alpha genes | excess Beta globulin forms Beta-4 (HbH)

Question 86

Plummer-Vinson syndrome

Answer 86

iron def anemia esophageal webs atrophci glossitis