Heme/Lymph (10/5/2013) Flashcards
10 of 10 Rekaps & Refs
- What 3 symptoms may key you into a patient with Hodgkin disease?
(1) Painless LAD (2) Night sweats (3) Generalized pruritis
- What major histology finding alerts you to a patient with Hodgkin disease?
Large cells with prominent nucleoli (Reed-Sternberg, or RS, cells)
- What pathophysiologic effect can Vitamin K deficiency have in a newborn?
Results in defective gamma-carboxylation of glutamate residues of factors II, VII, IX, & X
- What hematological test/value is elevated in Vitamin K deficiency? What condition related to this finding can result?
Results in elevated PT, leading bleeding diathesis (hemorrhagic disease of newborns)
- What does ITP stand for? What is the pathophysiology of this disorder?
Idiopathic thrombocytopenic purpura (ITP); Chronic autoimmune disorder in which antibodies against platelet glycoproteins cause platelet destruction and removal by reticuloendothelial system
- Under what conditions can a diagnosis of ITP be made?
Only when secondary thrombocytopenia (lupus, viral, infections, drugs) have been ruled out can ITP diagnosis be made
- What type of cells are essential for Hodgkin lymphoma diagnosis? Are they pathognomonic?
RS cells essential for Hodgkin lymphoma diagnosis but not pathognomic
- What are the distinguishing features of classic RS cells?
Large with abundant cytoplasm and s+ oval lobulated nuclei with large nucleoli
- What cell is associated with Nodular sclerosing type of Hogkin disease? What characterizes this cell?
Lacunar cell (variant RS) with retraction of plate cytoplasm producing an empty space (lacuna)
- What are 3 conditions in which target cells are seen?
Seen in thalassemia, HbC disease, and liver disease
- How is sickle cell anemia related to the spleen? What consequences may this have?
Cause repeated splenic infarctions leading to splenic atrophy; Patients susceptible to infection with encapsulated microorganisms (e.g., Pneumococcus). Pneumococcal vaccine is required.
- What characterizes and/or accompanies DIC?
Characterized by excessive consumption of coagulation factors and clot formation throughout body, accompanied by diffuse bleeding and elevated PT/aPTT
- When considering DIC, what is used to rule out a functional deficiency of coagulation factors?
Low fibrinogen levels
- What 2 lab values/tests are used to confirm a DIC diagnosis?
High level of FDP and D-dimer confirm DIC, which can occur as a complication of sepsis
- What is the origin and clinical utility of D-dimer versus FDPs?
D-dimer formed only from degradation of fibrin, whereas FDP can result from degradation of either fibrin or fibrinogen = D-dimer much more specific indicator of both thrombin and plasmin activity; In patient with diffuse coagulopathy, increased D-dimer signifies simultaneous activity of both plasmin and thrombin, which is virtually diagnostic of DIC; D-dimer also useful screen for patient with suspected DVT or PE (as product of blood clot)
