Heme/Onc Flashcards
reticulocyte
immature RBC
blue color on Wright-Giemsa stain of reticulocytes =
residual ribosomal RNA
dense granules of platelet
ADP and calcium
alpha granules of platelet
vWF, fibrinogen and fibronectin
vWF receptor
Gp1b
fibrinogen receptor
Gp2b/3a
granulocytes
neutrophils, basophils and eosinophils and mast cells
specific granules of neutrophils
leukocyte alkaline phosphatase, collagenase, lysozyme, and lactoferrin
azurophilic granules of neutrophils
proteinases, acid phosphatase, myeloperoxidase and beta-glucuronidase
hypersegmented neutrophils
B12 deficiency/folate deficiency
neutrophil chemotaxis
C5a, Il-8, LTB4, kallikrein, platelet activating factor
monocyte
macrophage precursor
macrophages activated by
gamma interferon
histiocyte
macrophage in connective tissue
initiation of septic shock
LPS binds CD14
major basic protein
allows eosinophil defense in parasites
causes of eosinophilia
NAACP neoplasia asthma allergic processes chronic adrenal insufficiency parasites
contents of basophils cells
heparin, histamine, leukotrienes
basophilia seen in…
CML
IgE binding and degranulation
in mast cells
what prevents mast cell degranulation
cromolyn sodium
dendritic cell
bridge between innate and adaptive immunities
NK cell
innate immunity lymphocyte
B cell markers
CD 19, 20, 21
T cell makers
CD 3, 4 and 8
CD28
for T cell activiation
order of erythropoesis production
yolk sac, liver, spleen, bone marrow
HbF
fetal hemoglobin, has less affinity for 2,3 BPG allowing O2 extraction from mom
blood types
if you have the antigen, you dont have the antibody
- example AB is universal recipient due to no antibodies
- O is universal donor due to no antigens
mothers at risk of hemolytic disease of newborn
Rh- moms (have anti Rh antibody after exposure)
- give Rhogam to prevent problems
ABO hemolytic disease of newborn
in O mom, with A or B baby
- leads to jaundice, treated with phototherapy
order of hemoglobin electrophoresis
A Fat Santa Claus
alpha, fetal, sickle, C
vWF and factor 8
vWF protects factor 8
vitamin K clotting cascase
vitamin K is reduced in liver by epoxide reductase and then acts as a cofactor for 2,7,9,10,c anc s
why are newborns vitamin K deficient
lack enteric bacteria
main targets of antithrombin
thrombin and Xa
factor V Leiden
factor V is resistant to inhibition by protein C
acanthocyte (spur cell)
- in liver disease, abetalipoproteinemia (states of cholesterol dysregulation)
- acantho = spiny
basophilic stipling
- in lead poisoning, sideroblastic anemias, myelodysplastic syndromes
- aggregation of residual ribosomes
- in peripheral smear
dacrocyte (tear drop cell)
- due to bone marrow infiltration (cells squeezing out)
bite cell
G6PD deficiency
echinocyte (burr cell)
- seen in end stage renal disease, liver disease and pyruvate kinase deficiency
- different than acanthocyte, smaller and uniform projections
elliptocyte
seen in hereditary elliptocytosis, mutations in RBC membrane proteins
macro-ovalocyte
megaloblastic anemia (also includes hypersegmented neutrophils
ringed sideroblasts
- iron in mitochondria in sideroblastic anemia
- in bone marrow
schistocyte
in MAHA including DIC, TTP/HUS, HELLP, valves and aortic stenosis
target cell
HALT said to target HbC disease asplenia liver disease thalassemia
Heinz bodies
- seen in G6PD deficiency
- oxidation of hemoglobin
Howell Jolly bodies
- seen in patients without spleen
treatment of lead poisoning
dimercaprol and EDTA
- succimer in kids
findings in lead poisoning
- lead lines
- encephalopathy and erythrocyte stippling
- abdominal colic and anemia
- wrist and foot drop
orotic aciduria
- cant convert orotic acid to UMP (UMP synthase)
- megaloblastic anemia
- increase in orotic acid
non megaloblastic anemia causes
alcoholism, liver disease (no hypersegmented neutrophils)
diamond-blackfan anemia
- rapid anemia due to defect in erythroid progenitor cells
- short, craniofacial abnormalities and upper extremity problesm
drugs causing aplastic anemia
benzene, chloramphenicol, alkylating agents, antimetabolites
fanconi anemia
- DNA repair defect causing BM failure
- macrocytosis
- short stature, tumors/leukemia, cafe-au-lait spots, thumb defects
diagnose HS with…
osmotic fragility test
pyruvate kinase deficiency
- leads to less ATP, rigid RBCs, extravascular hemolysis
- in hemolytic anemia of newborn
where is cold autoimmune hemolytic anemia seen
mycoplasma pneumoniae and infections mononucleosis (MMM) - IgM
causes of warm autoimmune hemolytic anemia
SLE, CLL and drugs (methyl dopa)
packed RBCs
- increase Hb and O2 capacity
- for acute blood loss and severe anemia
platelets
- increases platelet count
- used to stop significant bleed (thrombocytopenia, platelet defects)
fresh frozen plasma
- increases coag factors
- treats DIC, cirrhosis, immediate anticoagulation reversal
cryoprecipitate
fibrinogen, factor 8, factor 13, vWF and fibronectin
- treats deficiencies in fibrinogen and factor *
hodgkin lymphoma distribution
bimodal
hints for hodkin lymphoma
- 2 owl eyes X CD15 = CD30
most common type of hodgkin lymphoma
nodular sclerosis
best prognosis of hodgkin lymphoma
lymphocyte rich
burkitt lymphoma association
- 8:14, c-myc
- starry sky with tingible body macrophage
- EBV
- jaw lesions or abdomen in sporadic
diffuse large B cell lymphoma assocations
- older adults
- Bcl-2
- most common
follicular lymphoma associations
- 14:18
- Bcl-2
- waxing and waning
mantle cell lymphoma
- 11:14
- cyclin D
- CD5+
- aggressive
marginal cell lymphoma
- 11:18
- chronic inflammation
primary central nervous lymphoma
- HIV/AIDS
- involves EBV
- distinguish from toxo via CSF
adult T cell lymphoma
- caused by HTLV (drug abuse)
- lytic bone lesions, and hypercalcemia
mycosis fungoides/sezary syndrome
- cutaneous T cell lymphoma
- CD4 cells with cerebriform nuclei
- Pautrier microabscess
- Sezary syndrome = T cell leukemia
multiple myeloma
- hypercalcermia, renal involvement, anemia, blone lytic lesions
- M spike
- infection
- amyloidosis
- iG light chain
- Rouleaux formation (RBC stacks)
WaldenstroM MacroglobulineMa
- no CRAB findings
- M spike
- IgM
- hyperviscosity syndrome
MGUS
- no crab
- 1-2% go to myeloma
Pseudo-Pelger-Huet anomaly
neutrophils with bilobed neutrophils after chemo
ALL
- in kid
- Down syndrome
- increase in lymphoblasts
- TdT and CD10
- to CNS and testes
- 12:21 = better
CLL
- commonest adult leukemia
- CD20, CD23, CD5
- smudge cells (crushed little lymphocytes)
richter transformation
CLL transforms to aggressive lymphoma, occurs with diffuse large B cell lymphoma
hairy cell leukemia
- mature B cells
- hair like projections
- no LAD
- marrow fibrosis (dry tap)
- stains TRAP
AML/APL
- MPO
- 15:17
- ATRA
Down syndrome - DIC
CML
- 9:22
- BCR-ABL
- low LAP
- treat with imatinib
polycythemia vera
- itching after shower
- episodic blood clots
- low EPO
- JAK kinase
essential thrombocythemia
- platelets
- bleeding and thrombosis
myelofibrosis
- increased fibroblasts
- massive spleen and teardrop
