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Step 1 > Heme/Onc > Flashcards

Heme/Onc Flashcards

1
Q

Define anisocytosis

A

Varying sizes of RBCs

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2
Q

Define poikilocytosis

A

Varying shapes of RBCs

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3
Q

Define reticulocyte

A

immature RBC

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4
Q

What is contained within the dense granules of platelets?

A

ADP and Ca

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5
Q

What is contained within the alpha granules of platelets?

A

vWF and fibrinogen

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6
Q

What is the vWF receptor on platelets?

A

GpIb

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7
Q

What is the fibrinogen receptor on platelets?

A

GpIIb/IIIa

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8
Q

What is the WBC differential from highest to lowest amount?

A

Neutrophils, Lymphocytes, Monocytes, Eosinophils, Basophils (“Neutrophils Like Making Everything Better”)

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9
Q

Hypersegmented PMNs are seen in what?

A

B12/folate deficiency

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10
Q

Which cell type is the precursor for a macrophage?

A

Monocyte

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11
Q

What activates a macrophage?

A

gamma-IF

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12
Q

Eosinophils defend against which type of infection?

A

Helminth

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13
Q

What are the causes of eosinophilia?

A

Neoplasia, Asthma, Allergic processes, CT diseases, Parasites (invasive) (“NAACP”)

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14
Q

Basophils mediate what?

A

Allergic reactions

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15
Q

What three things do basophils contain?

A

Histamine, heparin, and leukotrienes

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16
Q

What three things do mast cells contain?

A

Histamine, heparin, and eosinophil chemotactic factors

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17
Q

What is the MOA of Cromolyn sodium?

A

Prevents mast cell degranulation - used for asthma prophylaxis

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18
Q

Which two receptors do dendritic cells express?

A

MHC Class II and Fc receptors

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19
Q

Dendritic cells in the skin are called what?

A

Langerhans cells

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20
Q

B cells differentiate into what?

A

Plasma cells

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21
Q

Plasma cells release what?

A

Antibodies and memory cells

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22
Q

Cytotoxic T cells express which CD type and recognize which MHC?

A

CD8, MHC I

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23
Q

Helper T cells express which CD type and recognize which MHC?

A

CD4, MHC II

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24
Q

What is Hemophilia A?

A

Deficiency of factor VIII

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25
Q

What is Hemophilia B?

A

Deficiency of factor IX

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26
Q

Which form of VitK acts as a cofactor for the coagulation cascade: oxidized or reduced?

A

Reduced

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27
Q

VitK is a cofactor for what?

A

Precursors of factors II, VII, IX, X, and proteins C and S

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28
Q

What carries and protects factor VIII?

A

vWF

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29
Q

Antithrombin inhibits activated forms of which factors?

A

II, VII, IX, X, XI, XII

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30
Q

What is the MOA of warfarin?

A

Inhibits the enzyme VitK epoxide reductase which reduces VitK

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31
Q

What is the MOA of heparin?

A

Enhances the activity of antithrombin

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32
Q

What are the principal targets of antithrombin?

A

Thrombin and factor Xa

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33
Q

Protein C does what?

A

Cleaves and inactivates Va and VIIIa

34
Q

What is the very first step of primary hemostasis?

A

Transient vasoconstriction via neural reflex and endothelin release from endothelial cells

35
Q

WP inside endothelial cells holds what?

A

vWF and P-selectin

36
Q

TxA2 is a derivative of what?

A

COX

37
Q

What is the MOA of aspirin?

A

Inhibits COX and TXA2 synthesis

38
Q

What is the MOA of ticlopidine and clopidogrel?

A

Inhibit ADP-induced expression of GpIIb/IIIa

39
Q

What is the MOA of abciximab?

A

Inhibits GpIIb/IIIa directly

40
Q

What is the MOA of ristocetin?

A

Activates vWF to bind to GpIb

41
Q

Does infection cause a high or low ESR?

A

high

42
Q

Does pregnancy cause a high or low ESR?

A

high

43
Q

Does CHF cause a high or low ESR?

A

low

44
Q

Does autoimmune disease cause a high or low ESR?

A

high

45
Q

Do malignant neoplasms cause a high or low ESR?

A

high

46
Q

Does HbSS cause a high or low ESR?

A

low

47
Q

Does microcytosis cause a high or low ESR?

A

low

48
Q

Does polycythemia cause a high or low ESR?

A

low

49
Q

Does GI disease cause a high or low ESR?

A

high

50
Q

Does hypofibrinogenemia cause a high or low ESR?

A

low

51
Q

Is petechiae usually indicative or a qualitative or quantitative disorder of platelets?

A

Quantitative (thrombocytopenia)

52
Q

What is the most common cause of thrombocytopenia in children?

A

Immune thrombocytopenia (ITP)

53
Q

What is the most common cause of thrombocytopenia in adults?

A

Immune thrombocytopenia (ITP)

54
Q

What is the pathophysiology of ITP?

A

Auto-IgG against GpIIb/IIIa

55
Q

What lab finding is associated with ITP?

A

More megakaryocytes on bone marrow biopsy. Low platelet count. Normal PT/PTT.

56
Q

What is the common presentation of acute ITP?

A

Children, weeks after a viral illness. Self-limited.

57
Q

What is the common presentation of chronic ITP?

A

Females of child-bearing age. May be primary or secondary (SLE). IgG can cross placenta.

58
Q

What are the treatment options for ITP?

A
  1. Corticosteroids - adults with chronic form usually relapse
  2. IVIG - in acute setting with symptomatic bleeding
  3. Splenectomy - remove source of Abs and site of destruction - performed in refractory cases
59
Q

What is the pathogenesis of microangiopathic hemolytic anemia?

A

Pathologic formation of platelet microthrombi in small vessels causes shearing stress of RBCs passing through (schistocytes) which causes hemolysis.

60
Q

What are the lab findings of microangiopathic hemolytic anemia?

A

Anemia, low platelet count

61
Q

What are a few underlying causes of microangiopathic hemolytic anemia?

A

TTP and HUS

62
Q

What is the cause of thrombotic thrombocytopenic purpura (TTP)?

A

Inhibition or deficiency of ADAMTS 13 (usu an auto-Ab) which is necessary to degrade multimers of vWF into monomers. This causes increased platelet aggregation and thrombosis. Causes a form of angiopathic hemolytic anemia.

63
Q

What are the lab findings of TTP?

A

Schistocytes and increased LDH

64
Q

What are the symptoms of TTP?

A

Pentad of neurologic and renal symptoms, fever, thrombocytopenia, and microangiopathic hemolytic anemia.

65
Q

What is the treatment of TTP?

A

Exchange transfusion and steroids

66
Q

The hematopoietic stem cells expresses which CD?

A

CD34

67
Q

What is Bernard-Soulier syndrome?

A

Deficiency of GpIb receptors

68
Q

What can an acanthocyte (spur cell) indicate?

A

Liver disease, abetalipoproteinemia

69
Q

What can basophilic stippling indicate?

A

Anemia of chronic disease, alcohol abuse, lead poisoning, thalassemias

70
Q

What can a bite cell indicate?

A

G6PD deficiency

71
Q

What can a ringed sideroblast indicate?

A

Sideroblastic anemia

72
Q

What can a schistocyte indicate?

A

DIC, TTP/HUS, traumatic hemolysis, micropathic hemolytic anemia

73
Q

What can a teardrop cell indicate?

A

Bone marrow infiltration

74
Q

What can a target cell indicate?

A

HbC disease, asplenia, liver disease, thalassemia

75
Q

Where is iron absorbed?

A

Duodenum - enterocyte

76
Q

What is Plummer-Vinson syndrome?

A

Triad of iron deficiency anemia, esophageal webs, and atrophic glossitis.

77
Q

Sideroblastic anemia is due to what?

A

Defect in heme synthesis (usually due to X linked defect of ALAS)

78
Q

Lead leads to anemia by denaturing what?

A

ALAD and ferrochelatase

79
Q

In sideroblastic anemia, where is the Fe accumulating?

A

In the mitochondria

80
Q

What is the treatment of sideroblastic anemia?

A

B6

81
Q

Alpha thalassemia is due to what?

A

alpha globin gene deletions (chromosome 16)

82
Q

Beta thalassemia is due to what?

A

point mutations in splice sites and promoter sequences leading to less beta globin synthesis on chromosome 11

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