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Neoplasia Block > IID Blood and Tissue Parasites & ClDx clin manif of hemat disease > Flashcards

IID Blood and Tissue Parasites & ClDx clin manif of hemat disease Flashcards

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1
Q

Iron deficiency anemia sx

A

sx rel to decreased O2 carryign capacity of blood bc less iron, esp older pts, consider colon, pale eyes, blood in stool, constipation or change in stool (left sided colon cancer), high platelet count, low blood cell vol, TIBC tot iron binding cap high, ferriton and iron low means IRON DEFICIENCY, but if TIBC is also low then anemia from other chronic disease

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2
Q

Iron def pap smear

A

small cells (microcytic) rbcs smaller than lympho
hypo-chromatic aka PALE RBCs
poikolicytosis aka diff size/shape of RBC

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3
Q

Predisposing factors to iron def

A

loss of iron from menses etc, colon polyp blood loss, colon cancer causes anemia, pencil thin stool L side colon lesion, diet (not enough red meat, vegetarian)

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4
Q

Screening in Iron def

A

barium enema- white area in colon
apple core lesions-L sided obstruction is sx
screening colonoscopy at age 50 etc

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5
Q

Vitamin C deficiency sx

A 
bleeding gums
bruises
petechiae red dots
LOW HEMOGLOBIN LVL
SPLIT CORKSCREW HAIR
WEAKNESS from hypotension etc
anemia (need vit C as cofactor for bone marrow production with all cell lines)
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6
Q

Vitamin C def on smear

A

Blue RBCs (recticulocyte), a few of the RBCs are a bit bluish, bc vit C cant help with marrow production

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7
Q

Predisposing factor of Vit C def

A

malnutrition (diet)

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8
Q

What does vit C def cause (disease)?
what mech is vit C impt for?
vit C px?

A
  • vit C def is SCURVY
  • vit C impt for cross linking collagen and is a cofactor for prolyl and lysly hydroxylases
  • nutritional defs often overlooked
  • vit C def may dev within a month and be fatal
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9
Q

Vitamin B12 def sx

A

long duration confusion
walking problems (ataxic gait/unsteady)
Paraesthesias (loos of posn/vibration)
Romberg- loss of proprioception
Absent bilateral DTR (deep tendon reflex)
High mean corpusc vol (many causes eg alc)
Elevated METHYLMALONIC ACID (conversion of this acid needs b12 as cofactor)
NOT from ab’s to intrinsic factor

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10
Q

What is vitamin b12 cofactor for

A

Converting methylmalonic acid

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11
Q

Advanced cases of b12 def can cause

A

leukopenia, thrombocytopenia

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12
Q

Vitamin B12 deficiencies on histology smear

A

HYPER-SEGMENTED NEUTROPHILS
Polychromasia (diff colored cells)
Macrocytic RBCs (large RBCs)
blue discorloration not fully mature cells

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13
Q

Predisposing factors to vitamin b12 def

A

Inadequate absorption of nutrients, can cause pernicious anemia (eg automimm ab’s against intrinsic factor)
OR
Right colonectomy–missing site of B12 absorption (terminal ileum), or gastric bypass surgery

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14
Q

How to treat vitamin b12 def

A

Replenish Vitamin b12 through injection or sublingual

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15
Q

Which deficiency has high mean corpuscular volume?

A

Vitamin B12!

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16
Q

Malaria spp and mosquito type

A

Anopheles

Plasmodium falicparum, ovale, and vivax (last 2 are liver)

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17
Q

Malaria pathology

A

sporozoites from mosq saliva inj into host, virus enters liver cells, after 7-10 days liver cells lyse and rel infectious merozoites into bloodstresm, which enter RBC and dev into schizonts, some meroz dev into gametocytes to be taken up by another mosq

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18
Q

Malaria pathology in vivox/ovale

A

can form hypnozoites in liver

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19
Q

Toxins/clin features in malaria

A

FEVER

cytoadhrence to endothelium

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20
Q

Histo of malaria

dx

A 
thicc smears to find parasites in RBCs
thin smear to find spp 
may be ring form as torophozoite early on
diff as meorozoite (stippling)
Dx with RDT
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21
Q

Prophylactic tx (3)

A

Chloroquine if u dont have res (color queen)
doxy (but sun sens)
mefloquine for long time travelers (fly queen w luggage)

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22
Q

Tx for malaria

A

Artemesinian combo tx (ACT) used worldwide for falciparum (artist painting near scary false mask warrior)
IV artesunate
Malarone (atavaquone&proguinil) (Atova vampire queen w iguana), and COARTAM
Quinine/doxy (dining queen)

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23
Q

Plasmodium falciparum
(false mask guy)
sx

A 
7 d incub
Africa etc
RBC lysis (RBC headdress)
Irreg feverchills (irreg toga)
Severe, v high mortality 
CNS, pulm edema (gold lung plates), renal failure (renal rings), etc bc RBCs occlude brain, kidney and lungs
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24
Q

P falciparum histo

A

2 red dots on slides

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25
P vivax & P ovale | Sx etc
Hypnozoites (hypnosis warrior) in liver (liver shield) 48 hr fever/chills (days 1, 3) Spleen enlargement (spleen spot on cow) (can enlarge too much)
26
What should you treat P vivax (india)/ ovale(W africa) with, and what is important to be careful of?
Tx with primaquine! (primal queen blocking hypnosis) | Be careful of GPDH deficiency
27
Plasmodium malariae
fever chills every 72 hr (days 1 and 4) (quartile buttons 1 and 4 red) renal failure
28
Traveler's malaria
can be from any spp @ least 10 days incub no spec sx (ask pt if traveled!), jaundice late (liver spot), normal ish labs but INCREASED total bili and LDH
29
Why does malaria avoid heterozygous SS pts
bc spleen clears sickled rbcs before virus can burst, less cytoadherence, but homozygotes can still die (same w thalassemias)
30
Babesia vector sx
"vampire babes" ioxdes tick (same as lyme, robin), wooded areas, blood transfusion, placenta, NE asymp unless IC (microtic less severe, divergens more) Malaria like sx Sudden severe hemolysis (broken RBC windows) splenectomy pt (hole in shirt in spleen area)
31
Babesia histo | dx
``` Maltese cross (cross in sketchy) and ring formation seen together Dx: malaria like sx but didnt travel to malaria area, smear, pcr, fluor ab, etc etc ```
32
Tx
Atovaquone & azithromycin (atova vampire queen w crows for macrolides) (can also have quinine and clindamycin)
33
KINETOPLASTIDS | spp
``` diff bugs long orgs no good tx bc non oral and have sxe Trypanosom Leishmania ```
34
3 types of trypanosoma
T gambiense T rhodesiense T cruzi
35
Trypanosoma cruzi disease transmission and bug location
``` "cruizin thru che's gas" causes CHAGAS disease from reduviid/triatomine kissing bug poor housing conds S america bug defacates on skin, scratching ```
36
T cruzi | Acute, indeterminate, and chronic phase
Unilateral PUFFY EYE (chagoma/romana's sign) most asymp except kids indet: 10-30 yr latency chronic: organomegaly, cardiomegaly (saddle bag shaped like heart), megacolon (large gas pump), megaesophagus (snake w big throat)
37
T cruzi tx
NiFURtimox (fur boots on woman) BENZnidazole (CRUIZIN in my BENZ with my FUR coat on)
38
T gambiense dis transm
TSETSE FLY W african sleeping sickness rural, poor ("prince bruce to the rescue")
39
Trypanosoma gambiense sx
``` slow dev of wasting, coma, convulsions, etcetc OCCIPITAL ADENOPATHY (pearl necklace) ```
40
T gambiense Tx
EFLORNITHINE (IV) (think flowers) | suramin serum and melarsoprol soap if CNS ("i SURe am MELLow when im sleeping")
41
T rhodesiense pop animal etc
E africa sleeping sickness tsetse males, hunters
42
T rhod sx
acute febrile, rash w circular large lesion | facial edema, helaptosplenomegaly, adenopathy, CNS/ CSF, cardiac/renal,
43
Leishmania trans area
``` SAND FLY ("desert mania") Lutz-new world, phleb-old world ```
44
Leishmania sx forms
skin lesions (primary form) (painless raised border, looks like syphilis but not in genital) good Th1 immune resp, self healing new world: new-WET, old-DRY - mucocutaneous visceral: dissem of macros sys, poor th2 resp, high mortality, guy w black rash
45
Leishmania tx
sodium stibogluconate (steak t-bone offering)
46
Ancylostoma braziliensis
DOG/CAT HOOKWORM (larva on ground enters skin) | larva migrans dis w inflam
47
A braziliensis sx
Cutaneous- vvv itchy prurutic, serpiginous (wavy margins) parasite trying to find dog/cat intestines toddler in sandbox etc
48
Ancylostoma braziliensis tx
Oral IVERMECTIN to kill worm | topical thiabenz
49
Toxocara canis/catis
ROUNDWORM in dogs/cats ("wolfman in screamatodes III) | puppies or kids ingest egg
50
T canis sx
visceral-sys inflam from worm crawling, fever etc EOSINOPHILIA (pink marbles), allergy, diarr etc -ocular, larva in retina, can cause blindness (wearing mask
51
T canis Tx (and dx)
dx pcr | TX: ALBENDAZOLE (bendy chairs on wolf man)
52
Baylisascaris procyonis
RACOON ROUNDWORM, have to kill racoon poop with flamethrower
53
B procyonis sx
V SEVERE enceph, brain/eye no good tx, high mortality etc
54
Filaria (nematodes)
infx has swimming egg stage and adult stage immune resp LOW: (loa loa, onchocerca, wuchereria)
55
Wuchereria bancrofti
Brugian spp adults in lymphatics peaks at midnight, trans by mosquitos
56
W bancrofti sx
asympt early: usual, retrograde lymphangitis late sympt phase: chronic edema, elephantitis (MC hammer pants), hydrocele, DLA (skin), nodules/plaques
57
Wuchereria dx and tx
rapid ag detection tx: DEC (diet and carb zine) Ivermectin Penicillin for DLA immed Doxy to tx wolbachia that lives in filaria
58
Onchocerca volvulus
Filarial onchocerciasis causing RIVER BLINDNESS | trans by black flies, painful bite, skin, africa
59
O volvulus sx
skin disease w nodules in lower extremities and butt, eye disease w worm causing blindness (fly covering eye) black flies black skin black nodules black sight
60
Onchocercia dx tx
dx skin snips, dec patch test not used much bc systemic mazzoti rxn: can cause sepsis like sx from ag storm, blindness/death Tx: IVERMECTIN, dec
61
Loa Loa (fliaria loiasis)
``` EYE WORM adults in subcut tissue microfilaria in blood peaks in morning trans by chrysops fly ```
62
Loa loa sx
asymp allergic, CALABAR SWELLING, non painful eye worm, non inflam, no perm dmg
63
Loa loa tx
DEC (blue guy also reading diet and carb zine)
64
Pt in NE area shows malaria like sx-- which microbe?
babesia! (microti LESS severe than divergens)
65
Oozing nonpainful ulcer with firm raised edges and cetnral crator-- which microbe?
Leishmania! (cutaneous)
66
Inflamed rash on buttocks w squiggly line | and disease process
maybe onchocerca volvulus filaria, cutaneous larva migrans, DOG HOOKWORM, dog poops egg, egg hatches into larva, larva finds human host, worm tries to find dog intestines but cant cross bloodstream so wiggles around and causes inflam
67
What is an example of a sx Wuchereria bancrofti may cause?
elephantiasis (eg of scrotum) (MC hammer pants), OBSTRUCTS LYMPHATICS (ruffles on armpits)
68
What do you use to treat issue in girl with chronic slow lymphedema of leg?
WUCHERIA BANCROFTI | tx with PENICILLIN
69
loa loa sx and dx?
swelling blotchy rash, cellulitis etc Giemsa stain blood smear
70
What is a ulcer with firm raised edges and central crater (oozy, nonpainful) called?
swollen epitrochlear node (FOREARM LYMPH NODE) | in cutaneous leishmania

Neoplasia Block (16 decks)

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