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need to knows > Heme/Onc (F.A) > Flashcards

Heme/Onc (F.A) Flashcards

1
Q

erythrocyte lifespan

A

120 days

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2
Q

platelet lifespan

A

10 days

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3
Q

what is the vWF receptor on platelet?

A

Gp1b

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4
Q

what is the fibrinogen receptor on platelet?

A

GIIb/ IIIa

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5
Q

what is the order of leukocyte/ WBC differential

A 
Neutrophils (60%)
Lymphocytes (30%)
Monocytes (6%)
Eosinophils (3%)
Basophils (1%)
"neutrophils like making everything better"
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6
Q

what does a neutrophil look like normally

A

multilobed

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7
Q

hypersegmented neutrophil indicates? (6+ lobes)

A

megaloblastic anemia (folate or B12 deficiency)

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8
Q

band cells?

A

immature neutrophils. increased number suggestive of increased myeloid proliferation (infection or CML)

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9
Q

what are factors that attract neutrophils

A

c5a, LTB4, kallikrein, PAF, IL8

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10
Q

monocyte appearance?

A

large kidney bean nucleus
frosted cytoplasm
precursor to macrophage

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11
Q

what activates a macophage

A

gamma-interferon

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12
Q

jobs of a macrophage

A

(1) phagocytose

(2) APC- via MHC II

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13
Q

explain pathophys of sepsis

A

Lipid A in bacterial LPS (or LOS in Nisseria) bind CD14 on macrophages initiating septic shock (which goes on to cause greater inflamm/ cap perm, etc.

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14
Q

what does an eosinophil look like

A

bilobate nucleus with large eosinophilic granules

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15
Q

what causes eosiniphilia

A 
neoplasm 
asthma
allergic process
chronic adrenal insuff. 
parasite (helminth)

NAACP

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16
Q

what causes basophilia (very uncommon)

A

CML- myeloproliferative disease

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17
Q

what do basophils release?

A

heparin (for anticoag) and histamine (vasodilation)

also leukotrienes

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18
Q

how do mast cells degranulate

A

they bind IgE via Fc portion, and attach it to the membrane..upon coming across an antigen, the IgE will crosslink –> degranulation

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19
Q

what type of HS reaction is mast cells involved in?

A

HS Type 1

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20
Q

dendritic cell functions

A

(1) highly phagocytic
(2) APC- via MHC II amd Fc receptors (B7) .. link between innate and adaptive immunity (bc constantly sampling and presenting)

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21
Q

what cells are lymphocytes

A

B, T, NK

have lg nucleus size of RBC

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22
Q

Bcell markers

A

CD19, CD 20, CD 21

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23
Q

what can B cells do

A

(1) become plasma cells and produce ab
(2) live as memory cells
(3) act as APC - via MHC II

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24
Q

80% of circulating lymphocytes are

A

T cells

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25
Q

T cell functions

A

(1) cytotoxic T cells– CD8+ that respond to MHC I
(2) helper T cells– CD 4+ that respond to MHC II
[ remember “rule of 8”, and both express CD3]
(3) regulatory T cells

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26
Q

what is necessary for T cell activation?

A

CD28

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27
Q

what does a plasma cell look like

A

clock face chromatin
well developed golgi apparatus , abundant RER
eccentric nucleus
(found in marrow not usually blood)

28
Q

name the locations of fetal/ adult erythropoeisis

A

(1) yolk sac – 3-8 wk
(2) liver – 6 wk till birth
(3) spleen – 10-28 wk
(4) bone marrow– 18 wk till forever
“ Young Liver Synthesizes Blood”

29
Q

adult hemoglobin

A

HbA1 – 2alpha, 2beta

HbA2 – 2 alpha, 2 delta (rare, only seen increased in B-thal)

30
Q

fetal hemoglobin

A

HbF– 2 alpha, 2 gamma

remember “ always alpha, gamma goes, becomes beta”

31
Q

HbF vs HbA

A

HbF has greater oxygen binding avidity, therefore it is able to steal O2 from mother’s HbA.. this is because HbF has weaker binding to 2,3 BPG

32
Q

universal PLASMA donor

A

AB type

33
Q

universal BLOOD donor

A

O type

34
Q

universal PLASMA acceptor

A

O type

35
Q

universal BLOOD acceptor

A

AB type

36
Q

anti- A and anti- B are what type of antibodies

A

IgM (can’t cross placenta)

IgM stays in Mom

37
Q

anti-Rho (aka anti D) is what type of antibody

A

IgG (CAN cross placenta)

IgG can Go to baby

38
Q

Rh hemolytic disease of the newborn: mom status? baby status? path? t(x)?

A

mom= Rh neg
baby 1= Rh pos
baby 2= Rh pos, gets hemolytic disease
– upon delivery of 1st Rh+ baby, mom makes anti-IgG against D antigen. when carrying 2nd baby, IgG crosses placenta causes hemolytic d(x)
t(x)- RhoGAM- an exogenous anti-D IgG to prevent MATERNAL production of anti-D IgG

39
Q

Hemoglobin electrophoresis migration: from farthest to shortest distance migrated

A

HbA, HbF, HbS, HbC
“a fat santa claus”
why? bc HbS (has val not glutamic acid) so it is neutral
HbC (has lysine not glutamic acid) so it is positive

40
Q

HbS

A

in B chain, a valine is there instead of glutamic acid. makes a neutral pocket that can allow RBC polymerization and sickling

41
Q

HbC

A

in B chain, a lysine (+) is there instead of glutamic acid (-). not as severe as HbS bc no sickling

42
Q

PT measures which coagulation pathway

A

Extrinsic

43
Q

PTT measures which coagulation pathway

A

Intrinsic

44
Q

What factors are in EXtrinsic pathway

A

VII

45
Q

What factors are in INtrinsic pathway

A

XII, XI, IX, VIII

46
Q

what is Factor II known as

A

Prothrombin, active= Thrombin

47
Q

What is Factor I known as

A

Fibrinogen, active= Fibrin

48
Q

what activates prothrombin to thrombin

A

Factor Va

49
Q

what activates fibrinogen to fibrin

A

factor IIa, thrombin

50
Q

intrinsic pathway is activated by

A

subendothelial collagen

51
Q

extrinsic pathway is activated by

A

Tissue Factor

52
Q

what degrades fibrin

A

plasmin

53
Q

Hemophilia A- def?
Hemophilia B- def?
Hemophilia C- def?
mode of inheritance?

A

A- VIII —- XR
B- IX —– XR
C- XI —– AR

54
Q

role of vit K epoxide reductase

A

reduces vit K. reduced vit K is a cofactor to gamma glutamyl carboxylase which activates factors: II, VII, IX, X, prot C, prot S

55
Q

role or protein C and protein S

A

anti-coag!

inactivate Va, and VIIIa

56
Q

explain the steps of primary hemostasis

A

(1) endothelial damage– vasoconstriction
(2) VWF (from WPB and platelets) bind exposed collagen
(3) “adhesion”- platelets bind VWF via Gp1b which causes platelet release of ADP and TXA2
(4) “activation” - ADP induces GIIbIIIa on platelets
(5) aggregation- fibrinogen binds platelets at GIIbIIIa and links platelets

57
Q

what does Ristocetin do?

A

activates VWF to bind Gp1b on platelet

58
Q

acanthocyte= spur rbc

A
  • liver disease, abetalipoproteinemia
59
Q

basophilic stippling

A

lead poisoning, siderblastic anemia, myelodysplastic syndrome
found in blood stream

60
Q

teardrop cell

A

bone marrow infiltration (myelofibrosis)

61
Q

bite cell

A

G6PD

62
Q

Burr

A

ESRD, liver disease, pyruvate kinase def

63
Q

ringed sideroblast

A

sideroblastic anemia, excess iron in mitochondria, seen in bone marrow

64
Q

schistiocyte= helmet cell

A

TTP, HUS, DIC, HELPP, mechanical valve

65
Q

target cell

A 
"HALT" 
HbC
Asplenia 
Liver Disease
Thalassemia
66
Q

Heinz bodies

A

G6PD (sign of oxidation of sulfhydryl group deposited, leads to bite cell formation)

67
Q

Howell-Jolly Bodies

A

asplenia.

nuclear remnants not removed by spleen macrophages

need to knows (31 decks)

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