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Integrative Week Two > Heme/Immune > Flashcards

Heme/Immune Flashcards

1
Q

B12 def

A

neuro findings, high MCV

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2
Q

causes of B12 def

A

pernicious anemia (anti-IF Ab)
terminal ileitis
vegan

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3
Q

B12 def with normal B12

A

high homocysteine and methylmalonic acid

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4
Q

G6PD def

A

post sulfa drug hemolytic anemia

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5
Q

Hereditary Spherocytosis

A

mild anemia
high MCHC
splenomegaly
family history

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6
Q

Hyperhemolytic crisis

A

vaso-occlusion
splenic-sequestion
sickle cell patient profoundly anemic

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7
Q

Sickle Cell Complications

A

acute chest syndrome
salmonella osteomyelitis
avascular necoris of femoral head

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8
Q

Vaccines to give someone without spleen

A

pneumococcal
mening
Hib
(encapsulated)

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9
Q

TTP

A

fever, mental status changes
SCHISTOCYTES
renal dysfunction, low platelets

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10
Q

Cause of TTP

A

ADAM TS-13/vWF cleaving protease

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11
Q

CLL

A

older, massive LAD
spleen
WBC 30K with lymphs

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12
Q

CML

A

high WBC in all lines
mild illness
9:22/brc-abl translocation

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13
Q

CML treatment

A

imatinib

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14
Q

Acute promyelocytic leukemia

A

15:17 translocation

treat with all-trans-retinoic acid

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15
Q

Multiple Myeloma

A

anemia, renal failure, older

high Ca, high prot,albumin, narrow anion gap

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16
Q

Multiple Myeloma mechanism

A

osteoclast activating factors (Il-6)

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17
Q

ITP

A

post URI, normal WBC, HCT, platelets 5K

megakaroycytes on bone marrow biopsy

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18
Q

HUS

A

toxogenic E coli
child, bloody diarrhea than AKI
thrombocytopenia, anemia

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19
Q

Cis-platin/carboplatin

A

nephrotoxicity

acoustic nerve damage

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20
Q

Bleomycin/busulfan

A

pulmonary fibrosis

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21
Q

Vincristine

A

pierpheral neuropathy

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22
Q

Doxorubicin

A

cardiotoxicity

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23
Q

cyclophosphamide

A

hemorrhagic cystitis

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24
Q

Trastuzumab

A

mab against HER2, tyrosine kinase

CHF

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25
Q

Rituximab

A

ab against Cd-20

on most B cell neoplasms (NHL)

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26
Q

Omalizumab

A

anti-IgE

severe asthma

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27
Q

Bevacizumab

A

mab against VEGF

inhibits angiogenesis

28
Q

Infliximab

A

anti TNF

crohn’s, RA

29
Q

Abciximab

A

anti-glycorotein IIb/IIIa

some acute coronary syndromes

30
Q

Type I Hypersensitivity

A

preformed antibody
igE mediated
immediate symptoms

31
Q

examples of Type I hypersensitivity

A

allergy
atopy
anaphylaxis

32
Q

Type II Hypersensitvity

A

cytotoxic rxns of Abs against cells or tissus

33
Q

Examples of Type II hypersensitvity

A

Hemolytic anemia - Coombs

Goodpastures - antiGBM

34
Q

Type III Hypersensitvity

A

ag-ab complex deposition in tissue

35
Q

Examples of Type III hypersensitvity

A

Vasculitis
Sle,RA
serum sickness, post strep GN, Arthus reaction

36
Q

Arthus reaction

A

edema
necrosis
activation of complement

37
Q

Type IV Hypersensitivity

A

T cell mediated

delayed presentation, 24-48 hrs

38
Q

Examples of Type IV Hypersensitivity

A

TB skin test
contact dermatitis/poison ivy
GvH

39
Q

tight skin on face, hands, pulmonary fibrosis, esophageal dysmotility, renal disease

A

scleroderma - systemic sclerosis

Anti-Scl-70/anti-DNA topoisomerase 1

40
Q

proximal muscle weakness

elevated CK

A

polymyositis

Anti-Jo-1

41
Q

Asthma, eosinophilia, necrotizing vasculitis

A

Churgg-Strauss

P-ANCA

42
Q

Autoimmune hepatitis

A

40 year old women
acute, very high transaminases, +ANA
anti-smooth muscle antibodies

43
Q

anti-smooth muscle Abs

A

autoimmune hepatitis

44
Q

anti-liver/kidney/microsomal

A

autoimmune hepatitis in children

45
Q

Primary Biliary Cirrhosis

A

middle aged women
high alk phosphatase
liver dz
anti-mitochondrial Abs

46
Q

anti-mitochondrial Abs

47
Q

celiac disease symptoms

A

diarrhea, steatorrhea, wt loss

48
Q

celiac labs

A

anti-tissue transglutaminase (igA)

anti-endomysial

49
Q

Celiac path

A

blunting of intestinal villi

crypt hyperplasia

50
Q

Agammaglobulinemia

A

Xlinked/Burton’s
infant boy, 4-6 months
encapsulated organism sepsis
absent B cells

51
Q

Common Variable

A

young adult
recurrent sinusitis, pneumoa, bronchiectasis
splenomegaly, malignancies
GI malabsorption

52
Q

Congential thymic dysplasia (Di George syndrome)

A

CHD/truncus arteriosus
hypoparathyroid
facial abnormalities
Low T cells

53
Q

Recurrent Neiserria infections

A

terminal complment, C5-C9 deficiency

54
Q

Chronic Granulomatous Disease

A

boy, chronic catalase + infections (Staph, Ecoli, Serratia, Aspergillus)
nitroblue terazolium

55
Q

Chediak-Hegashi

A

AR chronic granulomatous disease

56
Q

Oculocutaneous Albinism

A

chornic granulomatous Disease

57
Q

Wiskott Aldrich

A

eczema, thrombocytopenia
X linked
combined B and T cell def

58
Q

SCID

A

agammaglobulinemia
lymphopenia
infant

59
Q

Cause of SCID

A

adenosine deaminase def

defected IL-2 receptors

60
Q

Leukocyte adhesion def

A 
infant
recurrent bacterial infections
persistent neutrophilia
absent pus
delayed separation of umbilical cord
61
Q

transfusion

urticarial, pruritis, wheezing, fever

A

allergic rxn
type 1 hypersen
against plasma proteins in transfused blood

62
Q

dyspnea, bronchospasm, hypotension, resp arrest, post tranfusion

A

anaphylactic rxn

IgA def patients get this from Abs to IgA after transfusion

63
Q

fever, chills within 12 hours of transfusion

no hemolysis

A

febrile, nonhemolytic transfusion rxn
Type II, host antibodies veruse donor Ags and WBCs
(most blood banks remove WBCs now)

64
Q

transfuion
fever, hypotension, flank pain, brown urine
immediate

A

acute hemolytic transfuion rxn

ABO mismatch

65
Q

jaundice

slow hemolysis 1-2 weeks after transfusion

A

delayed hemolytic transfusion rxn
anti-Kell, Duffy
extravascular, previous exposure

66
Q

shortness of air during transfusion

crackles

A

volume overload

67
Q

fever, dyspnea, noncardiogenic pulmonary edema on CXR esp after FFP

A

transfusion associated acute lung injury

Integrative Week Two (17 decks)

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